Work History – how important is it?

How many insurance carrier requests do you get for clarification regarding your provider’s work history?  If you’re running a practice with multiple providers, those requests can add up.  More and more, we’re finding that providers are not keeping their resumes current with beginning and end dates of employers.  All current and previous work history (within 10 years) should be reported on your state’s version of the universal online credentialing application (CAQH, as most know it).  Some insurance companies credential their providers for all practice locations within their service area.  If your CAQH application and resume aren’t up to date with end-dates of previous employers, it could cause delays in the credentialing process, as the carriers attempt to collect data regarding a practice you’re no longer affiliated with.  (Note: Resumes must be in MM/YY format in order to satisfy Employment Information on CAQH.) End-dates are especially important if you’re a Primary Care Provider because insurance carriers need to be notified within a specified time-frame so they can transfer patient panels and send out new insurance cards, if need be.  Make sure to check with your carriers regarding your contractual obligations and how much notice you need to provide them.

It’s very important that work history on CAQH is reviewed thoroughly upon each re-attestation.  When a provider moves from practice to practice and the account is managed by several different people, it can be tough to maintain accuracy.  As a provider, it’s within your best interest to update your resume each time there is a change in work history and forward it to your credentialing staff so they can make the necessary updates on CAQH.  The next time your application is reviewed by the insurance carriers during a re-credentialing phase, the changes will be recorded, resulting in fewer bothersome faxes and emails from the carriers.