Get Orthonet Caqh Notification New Individual 3 12 15

Filling out the Orthonet Caqh Notification New Individual form is an essential step in starting the credentialing process for new individual therapists. This guide provides a clear and supportive approach to each section of the form to ensure a smooth completion experience.

Follow the steps to complete the Orthonet Caqh Notification New Individual form successfully.

1. Select the ‘Get Form’ button to access the Orthonet Caqh Notification New Individual form and open it in your preferred editing application.
2. Fill in the facility DBA name and Tax Identification Number (TIN) in the respective fields at the top of the form.
3. Enter the facility address, including city, state, and zip code. Make sure these details are accurate, as they are crucial for the credentialing process.
4. For each new individual therapist, provide their first name, last name, degree, and CAQH ID number in the designated sections.
5. Indicate the start date for each therapist's completed CAQH application and whether they are affiliated with a group by selecting the corresponding 'Yes' checkbox.
6. In the section labeled 'Requested by,' print the name of the individual completing the form, along with their title and contact phone number.
7. Ensure the date is entered in the designated space before submitting the form to OrthoNet.
8. Review all entered information for completeness and accuracy. After confirming the details, you can choose to save changes, download, print, or share the completed form.

Complete your credentialing process by filling out and submitting the Orthonet Caqh Notification New Individual form online today.