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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

June 2017

Credentialing Reminder: Keep Provider Information Up to Date in CAQH

As a reminder, it is important to keep your information up to date in the CAQH ProView system in order for the provider credentialing process to run smoothly and efficiently.
If you are attempting to complete an application for credentialing with Harvard Pilgrim, keep in mind that until you have attested in CAQH ProView, your information is not current and the status of your application is incomplete. Once you have attested to your information and your application is marked with a status of “Initial App Complete” or “Reattested,” HealthCare Administrative Solutions’ (HCAS’) credentialing vendor, Aperture Credentialing, LLC, can begin the process of primary source verification.

Best Practices guide and other resources

The HCAS Recommended Credentialing Best Practices guide provides guidance on how to enter or re-enter information in the CAQH ProView system; how to correct errors commonly made when submitting a credentialing application; and how to use the self-registration functionality that allows providers to create a CAQH account and establish a user ID number.

The guide is intended to assist the provider community by highlighting the most common elements that require outreach to the provider during the credentialing process, as well as outlining several best practices to assist providers in completing their credentialing applications.

In addition to the new guide, the Credentialing Resources page on the HCAS website is an excellent source of information about provider credentialing and recredentialing. For further details on how to use the CAQH ProView system, and to access FAQs, manuals, and reference guides, visit the CAQH ProView website.

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Network Matters Archives

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Changes to Sleep Diagnostic and Sleep Therapy Program

Review of Inpatient Admissions for Appropriate Level of Care

Reminder: Concurrent Review for Inpatient Stays

New Publication on Healthy Eating for Older Adults


Reminder: Expanded Medical Drug Prior Authorization Program

ACA Risk Adjustment Data Validation Reminder: Medical Chart Requests

Update to StrideSM (HMO) Medicare Advantage Hysterectomy Criteria

Updates to Bariatric Surgeries Medical Review Criteria

Updates to Varicose Vein Procedures Medical Review Criteria

Update to Cardiac Event Monitors Medical Policy

Prescribing Statins to Members with Diabetes

Members’ Rights and Responsibilities

Biological Effects of Cannabis and Detriments to Adolescent Development


Telemedicine/Telehealth Payment Policy

Change in Format of Newly Assigned Practitioner and Provider ID Numbers

Credentialing Reminder: Keep Provider Information Up to Date in CAQH

Keep Panel Status and Demographic Information Up to Date


Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator