Primary Source Verification 101

As RubiconMD looks to expand, we have selected Medallion as our primary source verification partner to support our team throughout the process. Medallion is an industry leader in verifications, licensing, payor enrollment and provider credentialing that is SOC-II compliant. Companies that hold a SOC-II compliance certificate have been through rigorous (and ongoing) compliance measures to ensure security, confidentiality, and privacy of provider data. Medallion is also an NCQA certified primary source verification organization (CVO). NCQA stands for National Committee for Quality Assurance. When a verification vendor is NCQA certified, they go through a rigorous process to ensure safety in data collection, analysis, and continuous monitoring that meet industry standards. 

As part of this engagement, Medallion is here to make the process as easy and streamlined as possible. 

For Medallion, all communication and tasks are managed through their platform for documentation, visibility and transparency to all parties involved. No more emailing generic inboxes and being unsure where to send things to. It will all be managed and maintained in the Medallion Platform.

As a next step, you should expect the following:

1. You’ll receive a welcome email from Medallion prompting you to create an account. Please sign up as soon as you get this email.
2. Before Medallion can begin verification work on your behalf, your profile needs to have the following information:

Work History

• • Include at least 5 years of work history
  • Provide an explanation for any gaps greater than 6 months
  • If the provider has not been working for 5 years, please include a full work history from the time of licensure.

Disclosure Questions

• Each disclosure question must be answered
• For any question(s) where an answer is “yes”, an explanation must be provided

Basic Profile Information

• Basic profile must be filled out so that we can locate accurate primary source data

Licenses/Certifications

• Please ensure your license numbers and board certifications are present in our system
• CAQH profile must be attested in the last 90 days

In order to complete your profile as quickly and efficiently as possible, utilize the Data import feature they have to pull information directly from your CAQH profile.

• Please reach out to the Medallion Support Team (support@medallion.co) or use the “Let’s Chat” button on the Medallion platform if you have any questions.

Information we will be collecting:

• Personal Information
• Education & Work
• Documents
  • Existing State & DEA Licenses (current or expired)
• Certifications (current and expired)
• External Accounts login information (CAQH)
• Disclosure Questions
• Consent to E-Signature

Helpful Resources:

• Completing your profile:

https://www.loom.com/share/10c1a4dc710c4670ac144319e9bb736a

• Actioning Tasks:

https://www.loom.com/share/4c82b491ad64450b86a7ee7d8d3c137a

FAQ:

1. What does RubiconMD do with all this information? 

On behalf of RubiconMD, Medallion will perform Primary Source Verification, which is a cross reference with various databases to verify that our specialists have no sanctions that would hinder their ability to work on the platform. Medallion will verify a provider's NPI number, Board Certification, License(s), and do a background check with the Office of the Inspector General (OIG) as well as the System for Award Management (SAM). 

2. Will I be enrolled with payers? 

RubiconMD will not use the information provided for verification to enroll any specialists with payers, and will never do so without consent from a specialist. 

3. Why do I need to sign the “Limited Power of Attorney and Authorization to Release Information?

The Limited Power of Attorney and Release of Information allows Medallion to act as an agent, and what they do as an agent is limited by our business.

4. Will my employer be contacted? 

RubiconMD will not be contacting the employers of any specialists. The decision to inform an employer about your contractual work with RubiconMD is up to the discretion of the specialist. 

5. Do I need to upload malpractice insurance? 

No you do not. We provide claims-made Professional Liability insurance with tail coverage. Tail coverage is provided for all specialists. If any specialists leave RubiconMD, tail coverage is covered automatically at no charge on the existing ongoing Professional Liability policy. On Medallion’s platform, a document stating RubiconMD’s coverage has been uploaded on behalf of all specialists.