CAQH Profile Guide - Maryland

You’ll need an up-to-date CAQH profile that includes some specific pieces of information so that we can get you registered and credentialed in our network. This guide will walk you through the steps to prepare your profile for credentialing. If you need a hand, reach out to our team at credentialingteam@rula.com.

Getting started

Already have a profile?

Start at Step 2 - Update your profile with our specific information. It should take about 20 min.

Don’t have a profile?

Start at Step 1 - Create your profile. It should take around 90 min. You’ll need a few things ready:

  • Your NPI and license details
  • An updated CV/resume that has all your education and work history (All the dates on the CV/Resume for your history should have months and years to help complete the profile accurately).
  • Liability insurance policy where you are listed as the insured, with a minimum of $1M Occurrence and $3M Aggregate coverage
  • Name and contact information of 3 professional references

Not sure if you have a profile?

Check if you have a profile by filling out the CAQH form

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Steps to create or update profile

Step 1 - (New profiles only) Create a CAQH account

Step 2 - Complete basic profile info

Step 3 - Add Rula practice location

Step 4 - Add Rula credentialing contacts

Step 5 - Complete and review professional info

Step 6 - Authorize review 

Step 7 - Attest your profile 

Step 8 - Upload documents

Step 9 - Return to your Rula account to continue set up

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Step 1 - Create a CAQH account and profile

  1. Go to the CAQH registration page, review the instructions, then create and register your account.

Step 2 - Complete basic profile info

  1. Login to your CAQH profile
  2. Go to Personal Information, make sure all required fields are complete and the following details are included so that we can get you registered in our network:
    Field Information
    NUCC Grouping Behavioral Health & Social Service Provider
    Provider Type Include your primary license type (e.g. Clinical Social Worker)
    Practice Setting Inpatient/Outpatient or Outpatient Only
    Primary Practice State MD
    Name Include your name and any aliases that you use.
    Other fields Complete all other fields with your information.

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  3. Go to Professional IDs, make sure all of your active licenses are included and ensure all information is up-to-date. This should be the name that you use on both your Type 1 NPI and license.
  4. Go to Education & professional training, make sure that your information is up-to-date–including all Masters-level education information and any other high-level degrees (e.g. PhD, MD)
  5. Go to Specialties, make sure that your primary specialty matches the primary license you will be using to practice with Rula.

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Step 3 - Add Rula practice location

Part 1: Add practice details

  1. Go to Practice Details, click “Add Location” and go to the Practice Details tab. You will enter Rula-specific information in this step, do not enter your personal preferences. Please enter the following information exactly as provided so that we can register you with our network.

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  2. Go to the Location Address section and enter the following details:
    Field Information
    Practice Location Name MENTAL HEALTH SPECIALTY GROUP, PA
    Street 1 4445 WILLARD AVE
    City CHEVY CHASE
    State MD
    Zip 28015-3690

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  3. Go to the Digital Directory Information section and enter the following details:
    Field Information
    Practice Location Email credentialingteam@rula.com
    Practice Location & Appointment Website www.rula.com
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  4. Go to the Phone Numbers section and enter the following details:
    Field Information
    Appointment Phone Number 323-205-7088
    Fax Number 833-419-0181
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  5. Go to the Business Identifiers section and enter the following details:
    Field Information
    Tax ID 86-2493019
    Type of Tax ID Group
    Organization (Type 2) NPI 1801472634
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  6. Click “Save and continue”

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Part 2: Add provider at the location information

  1. Go to Provider at Location tab. Please enter the following information exactly as provided so that we can register you with our network.
  2. Go to Affiliation section and enter the following details:
    Field Information
    Please describe your affiliation with this location “I see patients by appointment at least one day per week on a regular basis”
    Provider’s Start Date Choose today’s date
    Is this your primary practice? If you do not have an existing primary practice in your profile, select “Yes”
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  3. Go to Practice Limitations and enter the following details:
    Field Information
    Select “Age”

    Enter minimum of 5 and maximum of 99


    *This will not affect the patient age preferences you’ve shared with Rula

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  4. Go to Patients and enter the following details:
    Field Information
    Do you accept all new patients at this location? “YES”
    Do you accept New Patients at this practice Location? “YES”
    Do you accept existing patients with a change of payor at this location? “YES”
    Do you accept Medicare Patients at this location? “NO”
    Do you accept new Medicaid patients at this location?  “NO”
    Do you accept new patients from physician referrals (i.e., referring letter) at this location? “YES”
    Does this information vary by health plan?  “NO”
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  5. Click “Save and continue”
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Part 3: Add services and resources information

  1. Go to Services and Resources tab. Please enter the following information exactly as provided so that we can register you with our network.
  2. Go to Telehealth section and enter the following details:
    Field Information
    Select the following: “I provide telehealth services”
    Do you use a telehealth application or platform that is compliant with the Health Insurance Portability and Accountability Act (HIPAA)? “YES”
    Telehealth Service Type Audio/Video
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  3. Go to Payment and Remittance section and enter the following details:
    Field Information
    Billing Policies “This practice offers Electronic Billing”
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  4. Go to Office Personnel section and click “Add”

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  5. Select “Billing Contact” and enter the following details:
    Field Information
    What Support does the person provide? Billing Contact
    First Name Melissa
    Last Name Vilmin
    Street 1 PO Box 746878
    City Atlanta
    State GA
    Zip Code 30374-6878
    Fax Number 866-277-9071
    Email Address billing@rula.com
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  6. Select “Save and add another” and enter the following details:
    Field Information
    What Support does the person provide? Office Manager/Business Staff Contact
    First Name Gabe
    Last Name Diop
    Fax Number 866-280-0260
    Email Address credentialingteam@rula.com
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  7. Select “Continue”

  8. Go to Mailing Address section and enter the following details:
    Field Information
    Street 1 500 Westover Dr 
    Street 2 # 13619
    City  Sanford
    State NC
    Zip Code 27330
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  9. Go to Phone Coverage section and enter the following details:
    Field Information
    Select “This location provides 24 hour / 7 day per week phone coverage”
    Phone coverage type “Other”
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  10. Click “Save and complete”

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Step 4 - Add Rula credentialing contacts

  1. Go to Credentialing Contact and click “Add”

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  2. Enter this information, location address information is not required here:
    Field Information
    First Name Jeffrey
    Last Morris
    Fax 833-419-0181
    Email address credentialingteam@rula.com
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  3. Click “Save and continue”

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Step 5 - Complete and review professional info

  1. Go to Professional Liability Insurance and, using your current certificate of insurance, add the required details.
    • Reminder – Your liability insurance must include the following:
      • Your name listed as the insured
        • If you have an LLC and the insurance is under a group name, you must be listed as the owner and covered under the policy. Contact your carrier to have them add your name as owner under the group name.
      • Minimum of $1M Occurrence and $3M Aggregate coverage
    • Reminder – Please do not click the FTCA coverage checkbox–this is not a standard insurance. It is only for those who are employed and covered under a federal clinic program.
  2. Click “Save and continue”
  3. Go to Employment Information and include all of your healthcare work experience.
    • If you have fewer than 5 years of work experience, please include all experience while under supervision.
    • For employment gaps that exceed 3 months in your work history, please add the  explanation directly to your CAQH profile
    • Be sure to include Mental Health Specialty Group, P.A. in this section, using the start date as today’s date. This is still recommended even though you are contracted rather than employed.
  4. Go to Professional References and include 3 references. References from licensed professionals are preferred.
  5. Go to Disclosures and ensure all questions are answered correctly
    • Provide a detailed explanation for any questions answered unfavorably

Step 6 - Authorize for review

  1. Go to Authorize and select the Authorization Setting tab
  2. Select “Yes. Release my data to any organization that requests access”
    • This is essential for our partners to be able to review your profile. You cannot be credentialed with us or our payer partners without this selected.
    • Reminder: The general public never sees your CAQH profile, only authorized health plans and affiliations.
  3. Check “I hereby authorize the release of my full set of CAQH self-reported information as indicated above.”
  4. Click "save."

Step 7 - Attest your profile

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  1. Select “Review & Attest”

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  2. If any errors are present, make necessary corrections.

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  3. Select “Attest”

Step 8 - Upload required documents

  1. Go to Documents and upload required documents including:
    • (Only new profiles) CAQH release form
      • Print this form from the documents section in the profile navigation bar. On the document, print your name, then sign & date the form. Scan it to upload back to your profile. 
    • Certificate of insurance. This is usually a PDF document provided by your insurance carrier. 
    • Any additional state-required documents that are indicated

Step 9 - Return to your Rula account to continue set up

Great work! You are one step closer to seeing clients. Now that you have completed your CAQH profile, return to your Rula account to confirm that your profile has been updated and continue getting set up.

Reminders

  • Don’t change the required information you’ve added to your CAQH profile. This information links your profile to our network, please do not change it so that your credentialing process runs smoothly.
  • Please note that our practice location and credentialing contact are subject to change. We may request that you update our information.
  • Re-attest your CAQH profile every 120 days. You will receive email reminders from CAQH to reattest your profile.
  • Ensure that your NPI account is up to date. To ensure that your claims are not denied, log into your NPI account and ensure all information matches the details on your license.

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