Credentialing - TSCA vs. CAQH applications

[dc006]

Hi Alice and Michele:

As a new credentialing service in Texas, I have discovered that most hospitals ask for the TSCA to be completed along with the hospital's paperwork.  It is required by the Texas Insurance Board, but the State does not keep a copy of it for the provider.  Therefore, each time a provider seeks privileges at a different hospital, a new TSCA has to be completed, requested from the previous hospital, or a copy kept especially, if they are a new client.  And, it has to be no more than two years old.   I have had only one insurance carrier ask for the CAQH application to be completed for a provider.

Can the CAQH be used in conjunction with the TSCA or instead of the TSCA for a hospital or insurance company?  Both have a great deal to complete.

Thank you.

Denise

[Michele]

Denise,
    I have not heard of the TSCA form before.  Is it specific to Texas?  Most of the major carriers utilize CAQH and I have never had them ask for a TSCA.

Sorry   

Michele

[dc006]

Hi Michele:

Yes, the TSCA is for Texas providers, at least I have discovered that the hospitals in Texas require it.  It is the Texas Standardized Credentialing Application. The Texas Insurance Commissioner adopted the TSCA. The Application fulfills requirements of Senate Bill 544.  Use of this application form by Hospitals,HMO's PPO's is required for Credentialing of Physicians, but I have had to complete it for PA's and NP's as well. However the Texas Department of Insurance does not retain records of individual TSCA applications. The providers can contact the Entity they were credentialed with for the information.  The Insurance Board in Texas does not keep a copy as are the CAQH applications, which are centralized and can be viewed by each insurance company.  Both forms take time to complete.

Sincerely,

Denise

[Michele]

The thing is with CAQH you only do it once, then update when necessary.  If I had to do the TSCA's I would probably keep my own copy to prevent having to redo them.

Michele

[lhough]

I live in Texas and I keep a copy of TSCAs that have been completed for a provider.  I also have a "shell" saved with all fields completed for each provider and then fill in what is applicable to the carrier it is being submitted to, etc.  This is a big time saver since it is so time consuming with the length of the TSCA.  It may take a little time setting them up for each provider if you have several as I did, but boy once it is done it only takes a few minutes to finish and print for the provider's signatures.  You just have to remember to keep the information that is "pre-filled" up to date.

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