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Information Last Updated: 6/4/2019

Provider Credentialing

Credentialing is the process of obtaining and reviewing documentation to determine participation status in a health plan. The documentation may include, but is not limited to, the applicant’s education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Generally, the terms credentialing and recredentialing include the review of the information and documentation collected, as well as verification that the information is accurate and complete.

Credentialing Process

Brand New Day accepts the use of Council for Affordable Quality Healthcare (CAQH) ProView^TM, a service that provides a fast and easy way to securely submit credentialing information to multiple plans and networks by entering information just once. Application data can be submitted online at any time. This simplified credentialing process reduces paperwork and saves time. It is provided at no cost. Please be sure to grant Brand New Day access to the CAQH ProView application.

Brand New Day Also accepts the California Participating Physician Application (CPPA).

To become credentialed for the first time, you will need a current and complete application.

Please be sure to:

Complete all fields on the form or mark them N/A.
Include all prior and current practice locations.
Include identification numbers, such as the physician or provider’s Social Security number, National Provider Identifier (NPI), Drug Enforcement Agency number, unique provider ID and professional license numbers.
Answer all questions and provide explanations if needed.
Include the signed and dated attestation form.

Provide digital copies of your:

Curriculum vitae, including work history in a month/year format
Professional license or DEA certificate
Controlled Dangerous Substances (CDS) certificate
Copy of malpractice insurance face sheet
Summary of pending or settled malpractice cases

How long does the credentialing process typically take?

Credentialing typically takes between 60-90 days from the time a provider roster is received to the time a provider is reviewed at Credentialing Committee. Ensuring a provider’s CAQH profile is updated, that Brand New Day is authorized to access a CAQH profile, and that roster data is submitted accurately will all help reduce processing time.

A provider is no longer with our group or his/her information has changed. Can Brand New Day update the provider within its system?

The easiest way to have changes (of any kind) to your provider roster reflected is to re-submit your roster with the relevant changes inputted. For Terms, please ensure you include a “Term Date” in the respective field.

When will providers receive confirmation of in-network status?

Providers will receive a letter in the mail when they have passed credentialing. Please note that providers cannot see Brand New Day members until they have passed credentialing and have reached their contract effective date.

When can I start seeing patients?

Providers can only start seeing Brand New Day patients after they’ve been credentialed. In the case of direct credentialing that will be when they receive a Pass credentialing notification.

How do I receive an update on provider loading and\or credentialing status?

If you would like to know the credentialing status of your providers, please fill out all of the required information below under Form Submission. In the last field below that displays “Application Type”, expand the drop down box, and select “Request Credentialing Status Update” and press submit. We will receive your status inquiry and send out an email response back with an update within 72 hours.

Credentialing Forms

Click on the buttons below to download the forms to complete your Credentialing status.

CAQH Attestation Form

FULL CPPA Application

Supervising Physician Assistant Agreement

Mid-Level Provider Application

Form Submission

Please confirm the information below (including attachments) is complete & correct prior to clicking on submit. Any discrepancies may result in delay.
If you would like to know the status of your request, please follow the instructions listed on our FAQs section to request your Credentialing Status.

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