Credentialing

Onicol provides credentialing services that is overseen and facilitated by the Company's credentialing committee, Medical Advisory Boards and expert network. Credentialing procedures cover all Onicol Specialties and include program governance and oversight. The Credentialing Committee enforces policies and procedures that assign a senior clinical staff persons responsible for all clinical aspects of the credentialing program and provider selection criteria.

The credentialing plan requires review of the credentialing applications for completeness and accuracy before they are submitted to the credentialing committee. And we ensure the confidentiality of credentialing information, with limited access, for each provider going through the credentialing process. In addition, we re-credential providers every three years.

  • Full credentialing service
  • A focus on selected markets where we have extensive knowledge and expertise
  • JCAHO, NCQA and URAC accreditation
    • Credential Verification Organization
  • Determine Professional Reputation
  • Credentialing includes the following but is not limited to
    • License to practice
    • Hospital privileges
    • DEA/CDS registration
    • Board certification/residency completion/medical school graduation
    • Malpractice history
    • Malpractice insurance
    • Application processing
    • Medicare/Medicaid sanctions
    • NPDB query
    • Sanctions against licensure
    • Ongoing monitoring

Recruitment

An essential part of any malpractice system is a high quality low risk Provider Network. Onicol will develop networks for malpractice insurers and mutuals. Onicol's experts serve as a nexus for evaluating; identifying and recruiting the most qualify physicians. In addition, many mutuals can distance themselves from the recruitment and selection process since they are recruiting from the same pool of physicians with which they work. Onicol will either license the network or receive broker's fees for written coverage.

  • Through a network of experts Onicol is able to provide references of highly qualified providers
  • Onicol Experts will help recruit providers for customers who have entered into a long term arrangement with Onicol to provide:
    • Claims Management
    • Risk Management