Network Development and Credentialing
CBHM provides all network development and provider credentialing activities for College Health IPA. The network development department is responsible for identifying and maintaining the provider and facility directory. This is an ongoing project which is monitored closely to make certain that at all times provider numbers, diversity and specialties meet the expectation of our various business partners, therefore, providing a comprehensive choice to their members. The College Health IPA Provider Network is divided into two groups. 1) PODS (Priority Office Designations) which are multi- disciplinary group practices and 2) Wraparound Network which includes individual providers who are utilized when the member request is unable to be met by the PODS. Network development models have been developed to ensure that provider capacity is exceeded in all geographic regions where College Health IPA is contracted.

CBHM also provides the necessary provider credentialing activities. Two programs are provided by the credentialing department based on the contract with our business partner. Both delegated and non-delegated credentialing functions are available. Services provided include:

Sub-Delegated Credentialing

• Provider Completes College Health IPA Provider Application
• Business Partner Delegates Credentialing Activity to CBHM
• Provider To Meet NCQA Criteria
• Primary Source Verification
• Credential Committee Structure
• Re-credentialing
• CBHM Completes Credentialing & Contracts with Provider

Non Delegated Credentialing

• Provider Completes College Health IPA Provider Application
• Business Partner retains Credentialing Delegation
• CBHM Coordinates Credentialing Activities with Business Partner and Provider
• CBHM Contracts with Provider