Reference - Gemini1 Status Definitions
Gemini uses various status labels to communicate to the User where a particular Provider may be within or between an active credentialing cycle or event at any given time in its credentialing life cycle with Gemini.
Initial Credentialing Application Request - Request for application retrieval has been made by the User via template or individual upload request for 1) a Client specific application sent to the Provider for completion and return to Gemini for processing OR; 2) a CAQH application has been attempted to be retrieved by Gemini, yet unsuccessful due to incomplete/expired and the Client has requested Gemini to perform outreach to the Provider notifying of the need for CAQH update/re-attestation.
Recredentialing Application Request - Request for application retrieval has been made by the User via template, individual upload request, approval/submission via Recredentialing Due report for 1) a Client specific application sent to the Provider for completion and return to Gemini for processing OR; 2) a CAQH application has been attempted to be retrieved by Gemini, yet unsuccessful due to incomplete/expired and Gemini is performing outreach to the Provider notifying of the need for CAQH update/re-attestation.
Initial Credentialing in Process - Provider application has been received by Gemini via CAQH download or User upload (See Upload Article), preliminarily deemed complete and currently attested and now in the data entry, primary source verification process.
Recredentialing in Process - Provider application has been received by Gemini via CAQH download, directly returned from the Provider or User upload (See Upload Article), preliminarily deemed complete and currently attested and now in the data entry, primary source verification process.
Initial Credentialing QA Review - All primary Source verifications have been received and/or requested up to four (4) times with no response for an Initial Credentialing application and being reviewed by a Gemini Specialist for quality assurance prior to final file completion.
Recredentialing QA Review - All primary Source verifications have been received and/or requested up to four (4) times with no response for a Recredentialing application and being reviewed by a Gemini Specialist for quality assurance prior to final file completion.
Initial Credentialing Complete - All primary Source verifications have been received and/or requested up to four (4) times with no response for an Initial Credentialing application, QA reviewed and completed and sent to Client and/or available for download on the Provider record Credentialing page and/or the Completed File report. Client will now be obligated to provide a Next Recredentialing due date via the Approve functionality on the Provider record Credentialing page, Provider Inventory report or Completed Files report.
Recredentialing Complete - All primary Source verifications have been received and/or requested up to four (4) times with no response for an Recredentialing application, QA reviewed and completed and sent to Client and/or available for download on the Provider record Credentialing page and/or the Completed File report. Client will now be obligated to provide a Next Recredentialing due date via the Approve functionality on the Provider record Credentialing page, Provider Inventory report or Completed Files report.
Initial Credentialing Stopped - Provider application was received by Gemini via CAQH download or User upload User and in an Initial Credentialing in Process status, however a Client User has requested to stop the PSV process (See Provider Search- Credentialing Article). The Client will now be obligated to either approve (Client has processed the Provider credentialing in-house) or terminate the Provider. NOTE: Once the Stop Credentialing is selected, the Provider's PSV process may not be restarted at a later time, from the point that the PSV process was originally stopped. Should the User wish to restart the PSV process at a later date, the User will be required to resubmit a new Provider application (See Upload Article) request.
Recredentialing Stopped -
1. Provider application was received by Gemini via CAQH download, directly returned from the Provider or User upload and in a Recredentialing in Process status, however a Client User has requested to stop the PSV process (See Provider Search- Credentialing Article). The Client will now be obligated to either approve (Client has processed the Provider recredentialing in-house) or terminate the Provider. NOTE: Once the Stop Credentialing is selected, the Provider's PSV process may not be restarted at a later time, from the point that the PSV process was originally stopped. Should the User wish to restart the PSV process at a later date, the User will be required to resubmit a new Provider application (See Upload Article) request.
2. Provider application was previously in a Recredentialing Application Request status and after four (4) unsuccessful outreach attempts to obtain a pre-populated or complete/current CAQH application, the Provider's Next Recredentialing Due date has expired. The Client will now be obligated to either approve (Client has processed the Provider credentialing in-house), terminate the Provider or resubmit an Initial Credentialing application (See Upload Article) or Initial Credentialing application request.
Initial Credentialing Approved - Client has received the Provider completed Initial file, Committee approved and has provided a Next Recredentialing Due date via the Approve functionality on the Provider record Credentialing page, Provider Inventory report or Completed Files report. The Provider is now dormant until appearing on the Recredentialing Due report (See Reports - Recredentialing Due Report Article). Provider may now be included in Ongoing Sanction Monitoring and/or Expirables services if included in Client Service Agreement.
Recredentialing Approved - Client has received the Provider completed Recredentialing file, Committee approved and has provided a Next Recredentialing Due date via the Approve functionality on the Provider record Credentialing page, Provider Inventory report or Completed Files report. The Provider is now dormant until appearing on the Recredentialing Due report (See Reports - Recredentialing Due Report Article). Provider may now be included in Ongoing Sanction Monitoring and/or Expirables services if included in Client Service Agreement.
Terminated - Client has terminated its affiliation with the Provider/HDO, no further credentialing activity will be performed by Gemini. Clients are solely responsible for performing Provider / HDO terminations via the Client Portal.