Credentialing Alerts

Let's review how to set up Credentialing Alerts. You can review the short video or read the article for more details.

There are times when you will have a provider that is seeing clients but is not yet credentialed with certain payers. This can occur when you add a new provider to your clinic or if your clinic is going to start accepting a new insurance company. Adding a Credentialing Alert will warn you when trying to submit claims to an insurance with an active alert.

Navigate to Credentialing Alerts

1. Navigate to Providers > Provider List.
2. Locate the provider you wish to set up alerts for and click the icon.
3. Click on the Alerts tab.

Adding/Removing an Alert

Adding an Alert

1. In the Payer field, type in the payer ID or the payer name that you wish to add. 
2. Select the corresponding payer from the list. Payers listed in bold indicate that there is at least 1 insurance card mapped to it. Once selected, the payer will appear under Insurances Being Credentialed.                                                       

Removing an Alert

1. Under Insurance Being Credentialed, click the  icon next to the insurance you want to remove.
2. When the system asks if you are sure you want to remove the alert, click OK. 

Where do I see the alert?

There are 2 different areas that you will be able to see the credentialing alert.

• Insurance Invoicing Area for a specific client - If a service is attached to a provider with a credentialing alert, a  icon will appear next to that line. The client must have a corresponding insurance card. Hovering over the  will provide details on what insurances are pending credentialing for the provider (in relation to the client).
• Batch Primary - If there is a service line for a client attached to a provider being credentialed, a  icon will appear next to their name. The client must have an insurance card that is listed on the Credentialing Alert list. Hovering over the  will provide details on what provider has credentialing that is pending for that primary insurance. 

What happens if I try to invoice a service line with an alert?

The system will allow you to invoice claims with the alert attached, but only after you bypass the alert.

• Insurance Invoicing Area for a specific client - When a claim is invoiced using the  or  icons, a warning will appear asking if you want to continue creating an invoice. Selecting OK will bypass the alert.                                                         
• Batch Primary - When a client with a credentialing alert is selected in a batch, a warning will appear asking if you want to continue with the batch. Selecting OK will bypass the alert.