Provider Credentialing
Credentialing is required for all Daybreak clinicians. Daybreak has chosen to delegate provider credentialing and recredentialing for some plans to an NCQA Accredited Credentials Verification Organization, Verifiable, who is subject to established policies and protocol. Daybreak Health maintains the responsibility for ensuring that the delegated functions are being performed according to our standards. We have the right to approve, suspend, or terminate providers.
Our credentialing process is designed to protect clients and provide continued assurance that potential and/or currently participating providers meet the requirements necessary for the provision of quality care and service.
Getting Started with Daybreak Credentialing
A Daybreak Health Credentialing Team member will provide a direct link for you to use to submit your credentialing onboarding form along with any supplemental documentation.
We participate with CAQH ProView. Practitioners are required to have a CAQH ProView account, and make their information available to us for use. If a provider does not have a CAQH account, our Credentialing Team will set one up once you complete your onboarding form.
To be credentialed, you will need to include the following with your onboarding form:
- Demographic information
- Copy of curriculum vitae/resume, including work history in a month/year format (gaps of six months or more must be accounted for)
- Copy of current malpractice insurance face sheet with required minimum limits ($1mil/occurrence, $3mil/aggregate)
- A copy of your current state license
- A copy of your driver’s license
- A copy of your diploma/transcripts
- Summary of pending or settled malpractice cases and any necessary explanations
- Limited Power of Attorney and Release of Information
Minimum Standards for Participation
- Submit completed, signed CAQH application or state-specific application as needed, and update information when required.
- Possess required education from accredited medical or professional school, including residency and board certification if applicable.
- Hold current, unrestricted, and valid professional licensure in any U.S. state of practice, with highest clinical license allowing independent practice and treatment of mental illness.
- Maintain professional malpractice liability insurance; coverage limits for prescribers: $1,000,000/$3,000,000.
- Attestations required: disclosure of malpractice suits, absence of substance abuse affecting practice, absence of restrictions on practice, no felony convictions or improper acts related to profession,
- Absence from OIG/Medicare/Medicaid sanctions or suspensions
- Absence from Social Security Death Master list.
- Possess independent NPI number verified through NPPES by CVO.
Practitioner rights
During the credentialing process, applicants have the following rights:
Review information submitted
Correct erroneous information
Receive the status of their credentialing or recredentialing application, upon request
Practitioner recredentialing
Daybreak Health delegates to a CVO the recredentialing of all Daybreak Health Clinicians within 36 months (3 years, or more frequently in compliance with state requirements where applicable) of their last credentialing or recredentialing date. This includes assuring that the recredentialing process does not exceed the required timeframe from the point of receipt of a complete recredentialing application to committee decision. The intent of the recredentialing process is to identify any changes that may affect a Clinician’s ability to perform services as a Daybreak Health Clinician.
Contact Information
If you have questions during the credentialing process or would like further details on Daybreak’s Credentialing Policy and Procedures, please feel free to reach out to our Credentialing Team at the information listed below.
Email: credentialing@daybreakhealth.com
Phone: 571-899-4589