The WCSG Shared Audit Team has created a new reporting tool that is compliant with Health Plan, NCQA, CMS, HEDIS and State Medicaid requirements for credentialing.  The Standardized Delegate Report Template is a reporting tool that is used by medical groups delegated for credentialing functions and accepted by Aetna, Amerigroup, Centene Corporation, Cigna Health Care, Community Health Plan, First Choice Health Network, Group Health Cooperative, Humana, Molina Healthcare of WA, Northwest Physician Network, ODS HealthPlan Inc, OptumHealth, PacMed Clinics, Premera/Blue Cross LifeWise Health Plans, Regence Blue Shield, Soundpath Health and United Healthcare/Pacificare health plans.

The reporting tool was created by a work group consisting of medical groups, health plans and vendors with the focus on crafting one tool that all medical groups could use to report practitioner information to the health plans.  This one template, accepted by all health plans above, can alleviate some of the extra work for medical groups who maintain reports for each health plan they have delegation with.  It also assists the health plans with loading the data into their systems to better ensure accurate claims payment and online directories.

The tool may be downloaded here: Standardized Delegated Roster Template 2017

Any questions about the tool should be directed to the team’s co-chairs, Shannon Rochon or Michelle Pittman.