The Caterpillar Healthcare PPO NetWork does not require full credentialing for providers who provide only hospital-based services for the following types:
If any of the above types of practitioners provide service to members as a result of an independent relationship with the Caterpillar Healthcare PPO NetWork, the physician will be required to complete the credentialing process.
EXAMPLES OF PROVIDERS REQUIRED TO COMPLETE THE CREDENTIALING PROCESS
Additional categories of providers may be required to complete the credentialing process if providers hold independent relationships or contracts with the Caterpillar Healthcare PPO NetWork, are listed in provider directories, or as required by State statute.
The Caterpillar Healthcare PPO 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?
Failure to submit the documentation may result in claims not paying correctly for the provider.