Please complete and return a CAQH Provider Data Form. This will allow Preferred Care to add your name to its CAQH roster and will generate the mailing of a CAQH Welcome Kit to you, if you have not already received one.

Applicants are required to meet the minimum criteria for their specialty. Criteria are available by contacting the Preferred Care Credentialing Department.

Applicants who are starting their own practice or are not joining a practice/group already contracted with Preferred Care must complete a federal W-9 tax form and return it to the Credentialing Department to begin the contracting process.

New practice offices/locations for PCPs, OB/GYNs and Behavioral Health Providers will be required to undergo a practice site inspection, including a review of medical record keeping practices.

Upon receipt of the completed CAQH, the Preferred Care staff will begin primary verification of education, licensure, hospital privileges and other required items. The staff may send reference forms to your indicated references.

You have the right to review information submitted in support of your credentialing application with the exception of the contents of peer references.

Should any information obtained by Preferred Care vary substantially from the information you provide on your application or CV, Preferred Care will contact you immediately. You will have an opportunity to provide a written correction or explanation of the variance.

You may contact the Preferred Care Credentialing Department at (585) 327-2290 at any time to check the status of your application.

Upon receipt of the completed CAQH, the credentialing process usually takes 8-12 weeks.

You are not authorized to render services to Preferred Care members until you have a signed contract and/or received notification in writing of your provider number and effective date by a representative of the Preferred Care Network Management Department. A provider number will not be assigned to you until you have successfully completed the credentialing process.

Bachelor's or Master's degree in physical therapy from an accredited school

Submission of curriculum vitae (CV) which outlines education (including any continuing professional education), training and work history. The CV should have been updated within the last 90 days. The professional work history must go back a minimum of ten years or the number of years in practice, whichever is shorter.  Gaps in work history of over two months must be explained.

Current New York State license/registration to practice Physical Therapy, (as defined by New York State Title VIII Education Law Article 136) free from disciplinary action.  In addition, all past and present registrations in other states must be free from disciplinary action.

References from three health professionals who have been in a position to observe/evaluate applicant's clinical practice skills for a period of at least one year.  This is to include at least one physician in the field of Orthopedics, Neurology, Neurosurgery, Physiatry or a primary care physician.  All references must be from outside the applicant's practice site or current employer (see exceptions below):

(a)  If the applicant has been licensed less than one year and has no employment history, a substitute for a physician reference may be submitted by a school department chairperson or school officer who has observed the applicant in the clinical setting.

(b)  If the applicant has been continuously employed by the same employer since licensing, one (1) reference may be obtained from his/her current supervisor.

Verification of minimum annual professional liability insurance in the amount of
$1 million/$3 million.

Evidence of In-Plan Back-Up Coverage.

Beginning January 1, 2005 physical therapists will be required to submit proof of 40 continuing education credits per year or a minimum of 120 continuing education credits, annualized over any given three-year period.  Continuing education credits must meet the following criteria:

• Evidence based
• Relate to the scope of practice of physical therapy
• Accredited by a college or university or any other state or nationally recognized credentialing authority

Forty continuing education credits per year or a minimum of 120 continuing education hours, annualized over any given three year period.. Continuing education hours must meet the following criteria:

• Evidenced based; patient care specific
• 50% of credits to focus on neuroskeletal care

Accredited by the Council on Chiropractic Education (CCE) accredited college program,- or other university/college based institution. Online courses will be considered acceptable.

Chiropractors will be required to submit five (5) patient charts for review by a medical director at credentialing and recredentialing.  At this time you are required to submit five (5) Preferred Care member charts for peer review.  If you do not have five (5) Preferred Care members in your patient roster, you may substitute non-Preferred Care member charts for a total of five (5).  Please note that Preferred Care member charts do not require “blinding” of patient information.  Any charts of non-Preferred Care members should be “blinded” to ensure patient confidentiality.

(585) 258-8075

(585) 327-5757

Jan Richardson, Credentialing Program Manager  

(585) 327-5757