CAQH — credentialing obstructive processes and delays; who do you answer to?
I would like to file a complaint related to your format and processes which essentially cause delays in credentialing and ultimately prevent gainful employment. There are many elements to this, but two which stand out are the lack of competent staffing and the format of the forms which are biased toward certain types of providers.
The chat line assistance staff does not appear to have the expertise necessary to understand the myriad of providers, and are not able to provide the level of expertise needed to fill out the forms. It is basically like talking to a robot or listening to a broken record because there are no critical thinking skills or application.
The second issue is the computer format is not tailored to providers who may be locum providers or do not own clinics and labs. However, as one fills out the questions, the forms demand answers and information, which when answered directly and truthfully, does not apply because it is not intended for the type of provider filling out the mandatory questions. Its like trying to fit the many shapes and sizes of providers (circles, stars, triangles) into a square.in order to answer questions
That must be attested to, one gets sent down a path to answering questions which do not apply. It's a big mess! One problem I had was the demand for a run sheet and insurance data which does not apply to federal employees. Even though I explained this, I keep getting kick backs and rejections. No one seems to understand federal tort, and yet you are in the business of credentialing? So far my estimated pay losses exceed 8000.00 and loss of health insurance due to the delay as a result of caqh lack of knowledge related to various provider circumstances and what you can and can not demand of people in order to credential them so they can work. If you are entrusted to be a gatekeeper to whether people can put food on the table and pay their bills, should you not know what you are doing at a level that would not result in this kind of delay? You should be ashamed!
Credentialing bodies need to be regulated and have rules such as reasonable time limits to credential! Fines and penalties should ensue if you demand things that do not apply to the provider and this result in delays in employment. Caqh should pay a fine for each day over a certain time limit, example two weeks. I think most doctors would agree to about 1, 000 per day for unfounded delays and harassment.
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