Timely credentialing is essential to start participating with Select Health and get reimbursed as quickly as possible. While most delays are preventable, a few common issues can slow both initial applications and recredentialing reviews.
Common Initial Application Issues
1. Missing Application Release
Select Health uses the Council for Affordable Quality Healthcare (CAQH) for credentialing. This process will require you to submit release forms granting permission to view and verify your information. Be sure to enable Select Health permission to access your CAQH application in the “authorize” section. Delays can occur if:
- Required release/authorization forms are missing
- Uploaded documents are illegible or incomplete
Tip: Double-check that all signed release forms are included and clearly readable in your CAQH profile.
2. Incomplete/Inaccurate Application
You’ll start the credentialing process by submitting an online Join Our Panel application. If there is any incomplete or inconsistent information in your application, our team may need to follow up with you to get the missing details or correct errors. When applying, keep an eye out for potential issues like:
- Form fields that are missing information
- Conflicting details
- Incorrect or outdated information
Tip: Review your application carefully for accuracy and completeness before submission to avoid delays. View the Select Health Credentialing Checklist for more details on what information should be included.
3. Missing/Incomplete Hospital Admitting Privileges
Missing or incomplete admitting privileges are one of the most common issues with initial credentialing applications. This could mean that either:
- Privileges may not yet be established
OR
- An admitting arrangement hasn’t been provided
Tip: Ensure privileges are active—or clearly document your admitting arrangement—before submitting your application.
Common Recredentialing Issues
Recredentialing occurs every three years. This process is similar to initial credentialing but will typically take less time to complete. Some of the most common delays in the recredentialing process include:
1. CAQH Attestation
Providers must keep their CAQH profile updated and attested to in order for recredentialing to take place. Profiles not attested to within the required timeframe cannot be processed. Be sure that the email address in your CAQH profile is current, as unresponsive applications due to outdated contact information may result in termination.
Tip: Log in and attest your CAQH profile regularly—especially if updates need to be made.
2. Expired Malpractice Coverage
Current proof of malpractice insurance is required for recredentialing. We may not be able to complete recredentialing if:
- Coverage has lapsed
- Updated documentation has not been submitted
Tip: Upload your current malpractice certificate as soon as it renews to prevent gaps.
3. Missing/Incomplete Hospital Admitting Privileges
As with initial applications, missing or outdated admitting privileges can cause delays with recredentialing.
Tip: Keep your hospital affiliations and admitting arrangements up to date in CAQH and your credentialing records.
Staying proactive with your documentation helps prevent delays and ensures uninterrupted participation. By addressing these common gaps upfront, you can help streamline the credentialing process and avoid unnecessary delays.
Questions?
Contact us at provider.development@selecthealth.org or view the Select Health Credentialing Policies & Procedures Manual for more information.