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New Group and/or Provider Requirments

  • Updated and attested CAQH profile- 

    • You will need to list your new practice affiliation in CAQH including your start date.  

    • You need to be sure that your license and DEA are updated to the new state you will be working in, if you're being affiliated with a group in a new state

      • MAKE SURE TO CHECK UPDATED DOCUMENTS & ATTESTATION STATUS

  • Tax ID (W9 with pay-to address and CP 575/147 C letter for group). 

  • New malpractice policy or updated to current policy include your new employment. 

    • This will need to be uploaded to CAQH.  

  • Needs to list providers out as named insured on certificate, not just be a policy in the group's name.

  • You will need the group's primary billing(type II NPI)via NPPES

  • If applicable - Group's Medicare PTAN that you will be linked to.