Premier Healthcare Credentialing Assistance
Whether your practice is looking for credentialing, CAQH creation and management, or tracking inclusion, MPN Advantage is here to help
Frequently asked questions.
The California DWC defines an MPN as: A network of providers, including physicians, created to provide medical treatment for work injuries of employees in California. Self-insured employers or workers' compensation insurers may have an MPN. Under SB 863, an entity providing physician network services can also have an MPN. An MPN must be approved by the California Division of Workers' Compensation (DWC) before it can be used. Unless exempted by law or the employer, all medical care for workers injured on the job whose employer has an approved MPN will be handled and provided through the MPN.
MPNs must include acupuncturists and chiropractors as providers if they are commonly used by the employees being treated.
That is dependent upon the MPN. Most MPNs require that you not only disclose your mid-level practitioners, but credentialed them as well. This includes nurse practitioners and physician assistants.
No. Anthem is what we refer to as a "source" network. Providers may be credentialed on the "source" but not on smaller, more customized, MPNs. Custom MPNs select physicians already credentialed on source networks, and often require nominations to be considered This applies not only to Anthem, but to all primary source networks.
CAQH stands for "Council for Affordable Quality Healthcare. The CAQH, as defined by the CAQH website, streamlines provider data by using a standard electronic form that meets the needs of nearly every health plan, hospital, and other healthcare organization. In addition, the CAQH enables physicians and other healthcare professionals in all 50 states and the District of Columbia, to enter information free-of-charge into a secure central database and authorize healthcare organizations to access that information.
No; however, it is advised that you do. Many MPNs will accept your printed CAQH application in lieu of the standard CPPA, and some MPNs have access to the CAQH directly. If you do not have a CAQH number, you will be rquired to complete the CPPA, which is in excess of 30 pages.
Let's Work Together
MPN Advantage, a service of CMRS, was born out of a need that manifested when our clients experienced difficulty navigating the complexities of the workers’ compensation Medical Provider Network (MPN) system.