
New Group and/or Provider Requirments
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Updated and attested CAQH profile-
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You will need to list your new practice affiliation in CAQH including your start date.
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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
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MAKE SURE TO CHECK UPDATED DOCUMENTS & ATTESTATION STATUS
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Tax ID (W9 with pay-to address and CP 575/147 C letter for group).
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New malpractice policy or updated to current policy include your new employment.
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This will need to be uploaded to CAQH.
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Needs to list providers out as named insured on certificate, not just be a policy in the group's name.
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You will need the group's primary billing(type II NPI)via NPPES
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If applicable - Group's Medicare PTAN that you will be linked to.