Claim History Wizard Credentialing

Quick Reference Guide

Duration: 5:51

This is a video walk through of how to obtain a claim history from the wizard.

Transcript

Welcome to the CRICO Underwriting Training Series. This video features information about how to submit a Claims History/Loss Run Request via our online Claim History Wizard.

The Claim History Wizard allows current and previously insured individuals, CRICO institutions and non-CRICO organizations to request claims histories from CRICO directly.

As a credentialing specialist at a CRICO organization, you may have access to obtain this document through CRICOs database, XMAPs. Please note that the Claim History wizard is an alternative and may be used when any of the following occur:

• You do not have access to the CRICO database, XMAPS.
• You are attempting to obtain a claim history for an employee (i.e., a non-physician) .
• You attempt to obtain a claims history through XMAPS for a physician, and you are instead directed to this portal. This occurs when the physician you are requesting has activity on their claims history record.

To Begin

1. Google CRICO and click on the link, or enter www.rmf.harvard.edu into your web browser.
2. Navigate to Contact Us from the About tab at the top of the page and then click Claims History Request.
   
   OR
   • Scroll down to the Contact Us link at the bottom left-hand side of the homepage, and then click Claims History Request.
   • You can also navigate to the Claim History Wizard by clicking on the CLAIMS HISTORY request here icon in the center of the CRICO homepage,
   • Go directly to: www.rmf.harvard.edu/claimshistory to start the request.
3. Choose the corresponding option for the clinician, either Currently CRICO Insured, or No longer insured by CRICO. (For this training video we will use the No Longer Insured button in our example.)

As a Credentialing Specialist requesting a claims history for a provider, we will now walk through the process:

1. There will be two options to indicate whether a claim history is being requested for a physician (MD, DDS, DPM, DMD, DO) or an employee (this includes all allied health professionals: technicians, assistants, technologists; general nursing: RN, LPN; advanced practice clinicians: CNP, PA, CRNA, CNM; as well as psychologists, LICSW and PhD).
   Click on the applicable button and you will be directed to an online request form.

2. Fill out all required fields indicated by a red asterisk*

3. All requests require a waiver form authorizing the release of information signed by the clinician. Authorizations need to be signed and dated within the last 6 months.

   1. There is a sample release form on the page, you can click to download a release form if you don’t have one of your own.

   2. If there is not an option to upload a release form, you have not selected the correct options on the first screen. You can click the Back button on your browser and change your selections.

   3. When completing the form, indicate if the claim history should be sent to a State Board of Licensing/Licensure by entering the two letter state code in the corresponding field. Please include contact information at the state board or any special instructions in the Note to Underwriting section.

      Note: BORM’s Malpractice History Waiver for Release of Information is still required. Forms are available by logging onto BORM’s website. The physician may also write this waiver themselves.

4. Bulk Requests: You can submit additional requests by providing the same required information for all additional clinicians in the ‘Bulk Requests’ section. Please separate each name by semicolons. A signed release form is required for each individual.

5. If your request is urgent, please use the Note to Underwriting section to let us know any additional information you would like to share about the request, such as urgency, or an address you would like the request to be mailed.

6. Confirm that you have the necessary authorization to obtain a claim history on behalf of a CRICO insured provider and verify the recipient email address by checking the box in the Confirmation and Follow-Up Section.

7. Click Submit.

   • Please Note, there is a $25 administrative fee is applicable for requesting claim histories on behalf of individuals who are no longer in the CRICO program. However, if this request is initiated by a CRICO institution or existing insured clinician, this fee does not apply. We will waive the $25 fee for former CRICO-insured clinicians who are returning to the CRICO program. Please indicate Prior CRICO-insured returning to the program in the Note to CRICO Underwriting field on the request form. Once you submit the request, you will be automatically brought to a payment page and you can just stop there.

   • You will receive a confirmation email indicating that your request has been received and will be processed within 5 business days.

   • If, as in our example, the provider is no-longer insured, the claim history wizard will automatically bring you to a PayPal payment page. However, the processing fee is waived for Credentialing Specialists of our Sponsoring Institutions. Therefore, you can stop and close out of the browser once you have submitted your request.

   • Once Underwriting has secured and reviewed all documentation, the claims history will be prepared and sent within five business days of payment.

   • Please keep in mind that duplicate requests and follow ups can cause delays and reduce service times for claims history requests.