Updates - New Upload - Credentialing Application - CAQH Bulk Submission (Template)
The Credentialing Application Upload section of the Gemini Client Portal is the area the User may upload multiple Providers (bulk template) for Gemini to begin the application gather and PSV process for those Clients who source their Provider Credentialing/Recredentialing applications directly from the Council for Affordable Quality Healthcare, Inc. (CAQH). This method of submission of Initial Credentialing / Recredentialing application processing requests is applicable and available ONLY to Clients with the ability to access Provider credentialing application/information through an account directly with the CAQH.
Template Upload - The User must first toggle On Template Upload in order to access the Credentialing Application Submission screen whereby the most current Gemini1 Credentialing Application upload template can be downloaded for use than then uploaded once readied for submission to Gemini for processing. Upon completion and readying of a CAQH credentialing application submission template in Excel, it is recommended that the User name the particular template using a naming convention that will clearly differentiate that template from past/future template submissions (i.e. ABC Health Pan Cred Template 040120). Once readied and named, the User may then drag and drop (or by browsing and selecting from the User's internal library) into the upload template file area and click the Upload bar. Thereafter, the User may (HIGHLY RECOMMENDED) see the results of the template submission in the Updates-Upload History section of the Client Portal (See Updates-Upload History Article(s)).
Template Construction (Excel) - Upon opening the CAQH credentialing application submission template in Excel, the User will be guided by the first row as to the required fields and specific field format for submission. Also included within the template is a Field Dictionary which provides the User with more detailed information by field as well as a data example of acceptable field value for a more visual guide and comparison of the data you have entered for validation that it is correctly formatted. NOTE: The first two rows MUST remain exactly as shown on the template, all present + Columns (DO NOT DELETE COLUMNS) or the entire template, if altered, will be rejected.
Required Fields - Required fields are indicated in RED within the first row of the CAQH credentialing application submission template, as well as in the Field Dictionary.
Additional Addresses - The CAQH credentialing application submission template requires population of the Provider's Primary Office (practice) Address and contact information as indicated in Red. The User does have the option to include up to two more additional addresses and contact information within a Provider's record/line item. Although additional addresses are not required, should the User include, the additional address will be subject to the same template field formatting as the required Primary Address. The additional address will also require the indication of an Office (Address) Type (i.e. Credentialing Contact, Alternate Practice Location, Home, etc.).
See Field Dictionary - Within the first row of the CAQH credentialing application submission template, those fields that have "See Field Dictionary" indicated, must be populated with a value exactly listed within the coinciding field's value tabs included in the template (i.e. Suffix of Junior must be populated within the Suffix field on the Provider's line item as "Jr", as shown in the Suffix tab listing of the template).
Standalone - Indication that the Provider, despite overlapping in multiple groups (Linked Plans), within Alliance models, Managed Service Organizations (MSO) type Clients, will not share the earliest Recredentialing Due date but keeps the Clients specific Recredentialing Due date, either permanently or over one Recredentialing three-year cycle.
NOTE: DO NOT ATTEMPT TO REPLICATE THE TEMPLATE AS THIS MAY BE CAUSE FOR FORMATTING ISSUES RESULTING IN SUBMISSION REJECTION. PLEASE USE THE TEMPLATE PROVIDED AND DO NOT ALTER COLUMN HEADERS OR THE FIRST INSTRUCTIONAL LINE OF THE TEMPLATE. PLEASE STRICTLY ADHERE TO THE INSTRUCTIONS WITHIN THE SECOND ROW (AND FIELD DICTIONARY) AND DO NOT DELETE THIS ROW.