Have a question about the credentialing process? Need to download a form? We're here to help.

Forms:

• Oregon Practitioner Credentialing Application
• Recredentialing Form

Some General Questions and Answers:

1. Q. Are you NCQA or URAC Certified?
   A. No. IPS will credential to NCQA, URAC or TJC standards.


2. Q. Do you offer a credentialing or recredentialing application for clients to use?
   A. Yes. IPS uses the latest version of the Oregon Practitioners Credentialing Application, listed
   under forms.


3. Q. Do you follow up if information is missing from the application?
   A. Yes. IPS makes up to three requests for missing information from a provider to ensure a complete application packet is returned to you. We pride ourselves on exhausting all resources to check an applicant's credentials and will communicate with the applicant to determine a course of action during a difficult time.


4. Q. How many requests do you make to obtain verification from hospitals, training facilities and
   other agencies?
   A. IPS makes three requests for information prior to contacting the client and discussing alternative methods to check qualifications if possible.


5. Q. What is the turnaround time on an application?
   A. Initial applications average 40-60 days depending on the applicants' work history and yearly timing. Rarely does an application exceed this time frame. The entire process is completed well within the
   120-day time frame NCQA allows. In 2009, for example, IPS credentialed 271 new providers for Lipa, averaging 53 days to complete; performed 338 recredentials on Lipa providers, averaging 24 days to complete; credentialed 217 new providers for Trillium, averaging 44 days to complete; and recredentialed 420 providers were processed, averaging 28 days to complete.


6. Q. What is your credentialing fee?
   A. The pricing structure depends on the specific needs of the client and costs associated with
   external organizations.


7. Q. How is the client informed of the completed file?
   A. Upon completion of the credentialing process the client can be notified via fax, email or mail. The client may request certified copies of the original file or a summary profile of the information.


8. Q. What does an applicant need to submit with the application?
   A. A completed application to include attestation and release pages, copy of current Oregon license to practice in that specialty, copy of current malpractice insurance facesheet, DEA certificate with an Oregon address or a written RX plan in place, written call share and hospital arrangements, a Curriculum Vitae (CV).


9. Q. Can an applicant check on the status of an application?
   A. An applicant can follow up on the status of an application by contacting IPS staff during normal business hours; 8:00 a.m. - 5:00 p.m., Monday through Friday at 541-302-6432 or
   toll free at 1-800-739-2333.


10. Q. What is an NPI and do I need one?
    A. A National Provider Identifier (NPI) is part of the Administrative Simplification Provisions of HIPAA. A health care provider who is a covered entity under HIPAA, is required to obtain an NPI and to use it to identify itself as a health care provider in HIPAA transactions no later than May 23, 2007. This number should eventually replace other practitioner numbers such as UPIN, Medicare/Medicaid and payer specific numbers. You can sign up or search for NPI numbers at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.


11. Q. How can I obtain a Federal DEA number?
    A. You can call 1-800-882-9539. The DEA also offers applications on their website at http://www.deadiversion.usdoj.gov/index.html


12. Q. How do I become a provider for the Oregon Health Plan?
    A. To apply to become a DMAP provider, contact DMAP Provider Enrollment at 1-800-422-5047 or e-mail questions to provider.enrollment@state.or.us. The website address for information/application is: http://www.oregon.gov/DHS/healthplan/tools_prov/providerenroll.shtml#forms.