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How do I use the navigation buttons on the left to complete my application?
The buttons are designed to make navigating through the universal application easy and efficient for those who don’t want to complete the application page by page. You may skip to any section in the application by clicking the appropriate button. You will need to complete all application sections prior to clicking the button in the Attestation section. While you may view the Attestation section at any time, the button will only appear when all required fields and documents are complete.
Why are only certain fields required to save a section?
All fields necessary for credentials verification to accrediting/certifying body standards (NCQA, URAC, Joint Commission, etc.) must be completed to save a section. Additional fields request information that health plans and hospitals deem useful to their individual credentialing processes.
What if a field doesn’t let me enter my answer?
Some fields limit your selection because answers need to be standardized for health plan and hospital provider directories and reports. If you cannot locate your answer in the list, select the one that is most appropriate for your practice.
What does the Save Changes button do?
When you click the button, new information on your current page is saved, but only if ALL required fields are complete and there are no formatting errors (invalid dates, typos, etc.). An alert message at the bottom of the page will indicate whether your changes have been saved or if you must correct errors. Be sure to click the button again once you have corrected the errors.
What does the Next button do?
When you click the button, you are taken to the next page in the application process if you have saved the new information on the current page. If you have not saved the new information, you will be prompted to save or delete it before you can move to the next page. If you choose to save it, an alert message at the bottom of the page will indicate whether your changes have been saved or if you must correct errors. If your changes were saved, you may click the button again to move to the next page. If you corrected the errors, you should click the button before clicking the button.
What does the Back button do?
When you click the button, you are taken to the previous page in the application process if you have saved the new information on the current page. If you have not saved the new information, you will be prompted to save or delete it before you can move to the prior page. If you choose to save it, an alert message at the bottom of the page will indicate whether your changes have been saved or if you must correct errors. If your changes were saved, you may click the button again to move to the next page. If you corrected the errors, you should click the button before clicking the button.
What does the Save This Record button do?
Some sections require the user to create a record to provide all appropriate information (e.g. in the Education section, the user will create one record for each university/college (s)he has attended). When you click the button, ProviderSource™ reviews all information in the specific record to make sure the information is accurate and ready to be saved. If your data is saved, the information fields will be locked for editing, and you will see the , and buttons appear. If your information is not saved, the information fields will remain open for editing with your errors displayed. Once you have corrected the errors, you may click the button or the button at the bottom of the page to save your record information.
What does the Edit button do?
When you click the button, the information fields open for editing so you may change your responses. To save your changes, click the button. To cancel your changes, click the button.
What does the Delete button do?
Some sections require the user to create a record to provide all appropriate information (e.g. in the Education section, the user will create one record for each university/college (s)he has attended). When you click the button, you will be prompted to confirm deletion of a specific record. To permanently delete the selected record, click the button. To cancel, click the button. IMPORTANT NOTE: When all records are deleted for a question, ProviderSource™ will reset your initial “Yes” response to a “No” response. This change is made because a “Yes” response requires additional information and record creation. If the “No” response is correct, click the button. If you do not save the “No” response, ProviderSource™ will prompt you to add a new record for that question the next time that you visit the page. You will not be able to Attest until you have saved a record for that question or saved the “No” response.
What does the Update button do?
Some sections require the user to create a record to provide all appropriate information (e.g. in the Education section, the user will create one record for each university/college (s)he has attended). When you click the button, ProviderSource™ checks the fields in your current record to determine if the information can be saved. If your data is saved, the information fields will be locked for editing, and you will see the , and buttons appear. If your information is not saved, the information fields will remain open for editing with your errors displayed. Once you have corrected the errors, you may click the button or the Save Changes button at the bottom of the page to save your record information
What does the Cancel button do?
Some sections require the user to create a record to provide all appropriate information (e.g. in the Education section, the user will create one record for each university/college (s)he has attended). When you click the button within a record, all information fields are reset and your changes are not saved.
What does the Add New button do?
Some sections require the user to create a record to provide all appropriate information (e.g. in the Education section, the user will create one record for each university/college (s)he has attended). In order to create multiple records within a category, click the button, and another record will open so that you may include additional information. To save your changes, click the button. To close the record and cancel your changes, click the link in the top right corner of the record.
Is my information saved when I log out?
No. If you make a change to your information (adding, editing, or deleting) and click , your changes will not be saved. You will be prompted to save your changes. You must click the button to save your current information.
Do I use my legal name or the name under which I practice?
You should list your legal name in the First, Middle, Last, and Suffix name fields. Any other names you currently use or have used in the past should be provided in the Other Names section.
Should I list my nickname in Other Names?
No. You should only provide the name(s) that you have used legally or professionally, or that appear on any of your credentialing documents (diploma, DEA certificate, state license, etc.).
Do I have to list all of my degrees in Degree Titles?
No. You should only list the degrees you want to appear after your name for correspondence and directory purposes.
Why is my primary residence address requested?
Your primary residence mailing address is required by your state to complete your application.
Can I enter a P.O. Box as my home mailing address?
Yes. If you prefer to enter a P.O. Box rather than a street address, simply enter the post office box information in the Street Address field.
Why must I provide my primary practitioner type and state(s) of practice?
These answers will determine which fields are required for completion prior to Attestation. ProviderSource™ will use your responses to automatically update your record to reflect these specific requirements.
Do I have to include my Date of Birth?
Your date of birth is required to complete the application. Your date of birth will be used to accurately verify your credentials.
Do I have to include my Social Security number?
Your Social Security number is required to complete the application. Your Social Security number will be used to accurately verify your credentials.
What is a DEA Registration number?
A Drug Enforcement Agency Registration number is a series of numbers assigned to a healthcare provider (such as a medical practitioner, nurse practitioner, or dentist) by the United States Department of Justice, which allows the provider to write prescriptions for controlled substances across all states.
I write prescriptions under several DEA Numbers, which one do I list here?
Enter only your personal DEA registration number.
What is a CDS Registration number?
A Controlled Drug Substance Registration number is a series of numbers assigned to a healthcare provider (such as a medical practitioner, nurse practitioner, or dentist) by a state, which allows the provider to write prescriptions for controlled substances in that state.
What is the Registration Number related to my practicing specialty?
The Registration Number may be assigned by a state to regulate a healthcare practitioner in lieu of licensing.
Do I have to enter expired credentials (DEA, CDS, Licenses, Board Certifications, etc.)?
Yes. You must enter all credentials you currently hold or have held as issued by a U.S. or Canadian licensing authority.
What if I can't find my specialty in the drop-down list?
The specialty list is compliant with the most recent HIPAA standards; therefore you must select your specialty from this list. If you cannot locate your specialty in this list, select the specialty that is most appropriate for your practice.
What is a professional school?
A professional school is one that grants the degree under which you practice, unless the degree was obtained through your undergraduate education.
What do I do if I went to more than one professional school?
Enter all professional schools attended, whether or not you completed your education at that school.
Can I combine my internship and residency into one record?
Yes. Enter Internship/Residency in the Type of Training field.
Do I have to list incomplete internship/residency programs?
Yes. You must list incomplete internship/residency programs.
What if my internship, residency or fellowship was rotating or transitional?
If your training program was rotating or transitional, please enter a separate entry for each rotation. For credentialing, you need to provide the specifics for each rotation including the specialty or department and the time associated with each.
What if there was no university affiliated with my training program?
You may leave these fields blank. They are not required to save the page.
Do I need to enter foreign teaching appointments?
No, only enter information regarding appointments in the United States or Canada.
Do I include my training facilities under healthcare facility affiliations?
No, only enter information regarding non-training related healthcare facility affiliations.
Do I need to enter foreign healthcare facility affiliations?
No, only enter information regarding affiliations in the United States or Canada.
Why must I enter Pending as my Privileges Status if my application is in process?
You must enter “Pending” so that ProviderSource™ can prompt you to enter the date your application was submitted.
Do I need to enter foreign professional liability and coverage information?
No, only enter information regarding the years you’ve practiced in the United States or Canada.
Do I need to enter foreign professional liability and coverage information?
No, only enter information regarding the years you’ve practiced in the United States or Canada.
Do I include hospitals where I did my training?
No. Do not include hospitals where you did your training.
What is meant by an Effective Date?
The Effective Date is the date that your current policy became effective. It is not the date that the policy was originally issued.
Do I need to enter foreign employment?
No, only enter information regarding practice in the United States or Canada.
Do I need to enter foreign practice location information?
No, only enter information for practice locations that are located in the United States.
Can I enter a P.O. box as my practice office address?
You should enter the address for the physical location of your practice. If you do not have a physical practice location, you may enter a P.O. Box; however, please note that this information may be used for provider directories.
Can I enter "same" in the address fields?
No, do not enter "same" in the any of the address fields. You may select the “Same As” radio button to copy the information.
What if I have the same hours every day? Do I need to list each day separately?
Yes. Please list the hours for each day separately.
My practice group is very large. Do I need to enter all of my partners' names?
Yes. Please list each name.
What if my office manager, billing contact and credentialing contact are the same person? Do I still need to list them separately?
No. You may select the “Same As” radio button to copy the information.
What exactly do you mean by Limitation?
A limitation is any restriction you have set on the gender or age of your patient population.
What is a Covering Colleague?
A covering colleague is a healthcare professional who regularly attends to your patients in your absence.
Why do I have to upload copies of my license, DEA Registration, ECFMG Registration, etc. when you are going to verify my status with the issuing agencies anyway?
Required documents are determined by state, health plan and hospital credentialing requirements. These provide a reference in the event the issuing agency is unable to verify your status.
How do I upload a document?
You may upload a document by clicking the link at the top of any page, or by clicking on the Audit Application Documents page in the left vertical toolbar.

From the Manage Documents page:
  1. Click the button to browse your computer files.
  2. Choose your file, click Open, and then click the button.
  3. Once your file has been successfully uploaded, click on the Type drop-down menu and select the appropriate Category and Type for the document you are uploading. Click Add.
  4. If the Category and Type require that the document be linked to a specific record, choose the appropriate record you previously created, or choose Create New Record from the Record drop-down menu.
  5. Enter an optional description of the uploaded file in the Description field.
  6. Click the button to complete the uploading process.

From the Audit Application Documents page:
  1. Click the Upload icon for the appropriate Document Type.
  2. Click the button to browse your computer files, choose your file, and click Open.
  3. ProviderSource™ will automatically populate the Title field, which you may change at any time. Enter an optional file description in the Description field. Click the button.
  4. The Upload menu will refresh with a confirmation message that the file has been successfully uploaded. Click the button once you are finished uploading documents for the selected Document Type.
What if I uploaded the wrong document?
If the wrong document was uploaded, simply click the button and delete the selected document. Follow the uploading process again for the correct document.
Do I need to upload copies of my expired documents?
No. When uploading a document on the Audit Application Documents page, you should only upload a copy of your current document. If you want to upload expired copies for storage purposes, you may do so by clicking the link in the top left corner of the page.
If I change my document information in Audit Application Documents or Manage Documents, does it change it in the application section?
Yes. This way you can easily update expiration dates and upload your new documents in one place.
If I delete a document on the Audit Application Documents page, will it delete all previous copies that I have uploaded?
No. Clicking the button on the Audit Application Documents page will only delete the most recent upload of your document. If you have uploaded a previous version, ProviderSource™ will display that version after you confirm deletion of your most recent version.
How does Attestation work?
Attestation is the act of confirming the validity of information included in the application. Once the application is complete, most healthcare organizations require re-attestation once every 90-120 days. To attest, visit the Attestation page, found on the left side toolbar. To complete the attestation, your application must be complete—if the application is incomplete, you will see a message detailing the missing components of your application. Once the application is complete, the Attestation section will guide you through creating both a digital signature and an eSignature to complete the attestation.
How do I create a digital signature?
When you reach the Attestation section, which you may access from the left side toolbar, you will be asked to create a digital signature. A digital signature is produced by using your mouse to script a digital image of your handwritten signature. This digital signature is placed on all documents, such as the release of information and the attestation, which would typically require your signature if the document was in printed form.
What is an eSignature?
The eSignature is created in accordance with government regulations, executed, adopted, and authorized by the user to be the legally binding equivalent of the individual's handwritten signature (e.g., when you use your user ID + bank PIN to bank online).
What is the difference between a digital signature and an eSignature?
A digital signature is a graphical representation of your signature (e.g., a scanned image of your signature). By itself it cannot be used to sign documents. An eSignature is a unique combination of data in accordance with government regulations, executed, adopted, and authorized by the user to be the legally binding equivalent of the individual's handwritten signature (e.g., when you use your user ID + bank PIN to bank online).
Why do I have to go through the Attestation process again when I change information or upload a new document?
When you click the “I Attest” button and submit your eSignature, ProviderSource™ creates a snapshot of your credentials information and supporting documents that becomes immediately available to your health plans and hospitals. Any changes to your information or documents are not made available until you authorize those changes by submitting your eSignature again.
In the Release of Information section, if I don’t see the healthcare facility or hospital for which I wish to authorize release of information, what do I do?
Available healthcare facility selections are pre-selected from your previously submitted Healthcare Facility Affiliations. If there are affiliated facilities for which you wish to authorize release of information that are not included in the current list, please return to the Healthcare Facility Affiliations and create a new record for the desired affiliation.
In the Release of Information section, if I don’t see the health plan for which I wish to authorize release of information, what do I do?
Available selections are generated based on the state(s) of practice previously submitted. If the health plan(s) for which you wish to authorize release of information is not included in the provided list, please contact us to request the addition of the health plan(s) to the ProviderSource™ network. You may email us at provider.support@medversant.com.
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