Credentialing is the process by which an organization obtains, verifies, and assesses an individual’s qualifications to provide patient care services - they need to make sure you have the licenses you say you do.
Credentialing is free for the provider and can be completed by anyone in the pharmacy with the information required.
Start by clicking "Check for a CAQH ID" if you think there is any possible reason you would have filled this out in the past, such as working in a health system.
You will note as you are going through this process that the system is built for physicians, such as only schools of medicine are built into their system and schools of pharmacy will need to be typed in.
You will need the following documents and dates:
NOTE: if your practice liability insurance is only at the store level, you will need to have your insurance provider send you a face sheet that includes your policy number and your name as a covered entity. If the face sheet does not include your name, your profile will not be approved! KPhA strongly encourages all pharmacists to have individual liability insurance (usually around $150/year).
A credentialing system built for pharmacists, by pharmacists, this free profile is simple to fill out, but not commonly used by insurers (yet).
Once you have credentialing proof that you are who you say you are, it's time to enroll.
See what's covered in these KMAP Bulletins:
Pharmacists As Providers and
Immunization Administration by Pharmacist Providers. All pharmacist-provided clinical services will move to the new provider type by June 1, 2024 - this includes administration of all vaccines including flu shots!!!
Make sure you are enrolling now to ensure you can continue to immunize your KanCare patients and keep them protected!
Two steps to get enrolled:
Resources
Step 1: Fill out the Provider Network Enrollment Request (Form 15-481), found at the bottom of their provider forms page, and submit
**Use this
page to help fill out the enrollment request form correctly**
This process can take anywhere from 3-12 months, so we encourage pharmacists to start on this process ASAP, even if they are not quite ready to initiate services!
Step 2: Contracting
**Use this page to help fill out the contract correctly**
BCBS KS Specialty Provider Representative for pharmacists - Heather Schultz
Heather.Schultz@bcbsks.com
785-291-7724
Heather will help you from start to finish - credentialing to billing. Please give Heather a call!
Video covering BCBS KS enrollment steps
BCBS KS continues to tell us that they will cover anything that is in the pharmacist's scope of practice and to reach out to them if you have a question about a specific code.
Preserving, protecting and advancing Kansas pharmacy practice through education, engagement, and advocacy.
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