PROVIDERS NOT REQUIRING FULL CREDENTIALING

The Caterpillar PPO Healthcare NetWork does not require full credentialing for providers who provide only hospital-based services for the following types:

  • Pathologists
  • Diagnostic Radiologists
  • Anesthesiologists
  • Certified Registered Nurse Anesthetists
  • Urgent Care
  • Emergency Medicine Practitioners
  • Hospitalists

If any of the above types of practitioners provide service to members as a result of an independent relationship with the Caterpillar Healthcare NetWork, the physician will be required to complete the credentialing process.

EXAMPLES OF PROVIDERS REQUIRED TO COMPLETE THE CREDENTIALING PROCESS

  • Anesthesiologists with pain management practices
  • Emergency Medicine Practitioners who have an ambulatory practice outside of the emergency department
  • Radiologists with interventional and or nuclear medicine practices
  • Urgent Care Practitioners who do not practice exclusively in the urgent care setting
  • Hospitalist Practitioners who do not practice exclusively in the hospital setting

Additional categories of providers may be required to complete the credentialing process if providers hold independent relationships or contracts with the Caterpillar PPO Healthcare NetWork, are listed in provider directories, or as required by State statute.

The Caterpillar Healthcare NetWork maintains final authority on determination whether a provider is required to complete the credentialing process.

WHAT DOCUMENTATION IS REQUIRED FOR PROVIDERS WHO DON'T REQUIRE FULL CREDENTIALING?

  1. Caterpillar Attestation
  2. Caterpillar Release of Information
  3. Caterpillar PPO Healthcare NetWork Questionnaire
  4. Current copy of provider’s state professional license(s)
  5. Current professional liability insurance
  6. Current W-9 for practice

Failure to submit the documentation may result in claims not paying correctly for the provider.