Resources for Current Clients

Thank you for becoming part of the Palmetto Credentialing family. Below you will find some helpful resources. If you have any further questions or concerns, please contact me directly.

National plan and provider enumeration system (Nppes)

Please be sure to have an NPI type one (individual national provider identification) before I start this process. An individual NPI is required for all providers utilizing any type of insurance. If you plan to bill insurance using your personal name and not through a private practice (meaning your social security number will be used as your tax id), then you will only need an NPI type one.

If you are a provider who is billing through their private practice under a separate tax id, you will also need an NPI type two. An NPI type two is classified as an organization and is required if you are using a tax id that is not your individual social security number.

Offices with multiple providers billing through the same tax id will also need to provide an NPI type two to me.

If you need to apply for an NPI type one or NPI type two, you can do so through their website.

Council for affordable quality healthcare profile (caqh)

If you currently do not have a CAQH profile, please apply for one. Your CAQH profile will be used by applicable insurance panels and will be used during the credentialing process. It is extremely important to keep this profile accurate as any delays in doing so may delay your application process.

Once completed, I will upload all supplemental documents and complete your profile.

Provider profiles

If you have chosen to setup your own provider accounts, you can find the links below to do so. Please note that I encourage you to do this step on your own as these accounts will be your accounts moving forward. I will need all login information after these accounts are setup. Please take note of your username, password and any secret questions you use.

A provider account is required for enrollment if you are applying for the OPTUM network. “Maintenance account” means that you will be able to access multiple features such as claims, remittance advice, member benefits, request prior authorizations, submit demographic changes and more. Each account varies in its features, but I do encourage you to utilize all of them.