Commercial Insurance & Hospital Credentialing Resources
CAQH
This is a free service and serves as a centralized credentialing database for providers. Once you sign up, you are able to input personal, professional, and practice information into the system and update it as needed. Once your profile is complete, the information provided will be available to organizations that require your professional and practice information for claims administration, credentialing, directory services, and more.
If you are planning to sign up with commercial insurance carriers, once you initiate the application process, this is where insurance companies turn to for credentialing information. The link below will direct you to the CAQH website to create a profile. Please keep in mind, you will be prompted to perform an attestation every 6 months.
Private Insurance Resources
In the Private Insurance Resource Guide (PIRG), the American Podiatric Medical Association (APMA) has researched, analyzed, and summarized different facets of the health care industry that are pertinent to the practice of podiatric medicine. While the guide provides background information and practical solutions for podiatric physicians dealing with private insurance and managed care issues, APMA is not rendering legal, coding, medical, or other professional advice. APMA encourages readers of the guide who need assistance to consult with an attorney who is knowledgeable about health insurance and managed care law in the state in question, and/or to seek regulatory guidance from appropriate federal or state officials. The guide does not cover every state and federal law and regulation that may relate to the practice of podiatric medicine, and does not tackle every possible issue concerning managed care or health insurance. Therefore, the guide should not be used as a substitute for a review of the actual laws and regulations of each state and the medical policy and claim procedures of private insurers. The materials contained in the guide represent the opinions of the individual authors and should not be construed as the opinion or endorsement of either the APMA or the APMA Health Systems Committee.
For the complete guide, please use the following link and login with your APMA member credentials: www.apma.org/PIRG
Hospital Privileging & Credentialing
While the need for doctors of podiatric medicine in the hospital is prevalent and podiatric physicians are qualified by their education, training, and experience to engage in foot and ankle surgeries and other procedures, all too often podiatric physicians are confronted with discrimination. To assist NYSPMA members in resolving difficulties that arise during privileging and credentialing processes, the American Podiatric Medical Association (APMA) , through its State Advocacy Committee and in coordination with the Health Systems Committee, developed a 4 part Hospital Privileging and Credentialing Resource Guide.
The goal of this guide is to provide APMA and NYSPMA members with tools and suggested approaches that will assist the podiatric physician to obtain appropriate hospital privileges. These resources are to help podiatrists obtain hospital privileges that are commensurate with their individual demonstrated competency.
For the complete guide, please use the following link and login with your APMA member credentials: www.apma.org/hospitalguide
