Provider Toolkit

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Provider Toolkit

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CREDENTIALING

Credentialing is required for all physicians who provide services to VNSNY CHOICE members, as well as all other health professionals and facilities that are permitted to practice independently under state law and provide services to VNSNY CHOICE members, with the exception of hospital-based healthcare professionals.

Our credentialing process is designed to protect members and provide continued assurance that potential and/or currently participating providers meet the requirements necessary for the provision of quality care and service. The objectives of the VNSNY CHOICE Credentialing Program are to ensure that:

  1. Members who join VNSNY CHOICE will have their care rendered by appropriately qualified providers
  2. Each provider applicant has equal opportunity to participate
  3. Adequate information pertaining to education, training, relevant experience, and other credentialing criteria is reviewed by the appropriate individuals prior to approval or denial by the Credentialing Subcommittee

These documents will help you with the credentialing process and enable you to adhere to the proper requirements designated and outlined in the Provider Manual.

Disclosure of Ownership and Control Interest Statement.

W-9

NYSDOH Provider Disclosure Form

Facility and Institutional Full Credentialing Application

Sample IPA & Delegated Group Roster Template

CHOICE SelectHealth HIV PCP Inititial Attestation

Social Adult Day Site Visit Toolkit (Checklist and Site Survey)

Last updated 4/8/2020

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