How to Complete your CAQH Profile

CAQH - Council for Affordable Quality Healthcare, is an alliance of health plans, providers and related organizations working together to make the business of healthcare streamlined and efficient.

CAQH verifies your background, education and license status to ensure you are qualified to provide MNT services to the patients who are members of the plans we partner with.

As a Foodsmart RD, you will complete questionnaires and upload documents. Our credentialing team will review your profile and then disseminate your information to the plans we contract with. With their approval you will be able to see patients as a representative of Foodsmart.

If you already have a CAQH profile, please skip to adding Foodsmart as a practice location.

To register for a new CAQH profile

Go to CAQH.org, select Login in the top right corner, and log into the Provider Data Portal
Scroll down to find the First Time Here? section to the right of the page
Follow the link to register here.
Read through the GETTING STARTED and BEFORE YOU BEGIN sections, then click Go to next section to create your account.
Complete the required fields on the registration page

The NUCC Grouping is: Dietary & Nutritional Services
Provider Type is: Dietitian
Be sure to use your personal email address

After registering your personal information and identification numbers, CAQH will email your login credentials and Provider ID

Select Log In by clicking this link from the email you received to continue setting up your account.
You'll be prompted to enter your new CAQH Provider ID (also listed at the top of your email, under your name). Continue setting up your CAQH account by entering your:
- SSN
- NPI
- DEA
- License Number
- UPIN
- TIN
Create your username, password and answer the security questions

From the CAQH Profile Data screen

Review and complete personal information and other demographic details
Enter all professional licenses, education and training details, as requested

Important: Do not leave any gaps in dates or processing will be delayed.

Add any specialties or certifications that you currently have

Practice Details

Enter the Location Address & Phone Number:

Foodsmart

2041 East St, PMB 1292

Concord, CA 94520

415-800-2311

Business Identifiers & Type 2 NPI:

Zipongo Health Provider Group

Tax ID: 84-3379970 (Group)

Organization NPI: 1972146694

Provider at the Location

Describe your Affiliation and Start Date with Foodsmart

Enter Information about Referrals and New Patients

Services & Resources

Answer Yes to Telehealth questions and select both Audio and Audio/Video

Skip the Services, Payment and Remittance, Worker's Compensation Information, Colleagues, Covering Colleagues Not at This Location, and Phone Coverage sections

Office Personnel and Credentialing Contact

Enter these details and check the box next to The office manager (Julie McCann) is also the credentialing contact at providergroup@foodsmart.com

Professional Liability Insurance

Add your own (Contractors/1099s), or Foodsmart’s if provided (Salaried/W2s). This must be added before you can fully complete your profile and attest.

Important

Your CAQH profile must be 100% complete and linked to your Medallion profile prior to being scheduled for visits with patients.
Attestations are only good for 120 days and must be renewed when they expire. Log into CAQH at least weekly to review and renew any attestations that are coming due.

For any questions regarding credentialing please access the CAQH Provider Guide or send an email to with subject: Credentialing Application.

How to Complete your Medallion Profile

Medallion is the system Foodsmart uses to conduct primary source verification, which is the process of “confirming that an individual possesses a valid license, certification or registration to practice a profession.”

Using Medallion, we validate a provider’s credentials directly from a primary source, such as former employers, government agencies, universities, and professional organizations.

⚠️Watch your inbox for your personal Medallion Invitation to start setting up your profile

Accreditation agencies such as the federal Centers for Medicare & Medicaid Services (CMS), the National Committee for Quality Assurance (NCQA), as well as The Joint Commission all require primary source verification.

Our organization follows the standards set by CMS and NCQA so we can be reimbursed for the medicaid services we provide to our patients.

⚠️Please Note:

Active and Pending licenses reflected in your Medallion profile are the indicators that you may be scheduled with and see members in a given state.
If your license for any state is not listed in Medallion or the license has expired, you will not be scheduled with members in that state and any future visits on your schedule will be removed.

💡TIP:

We use the data you enter into Medallion to create auto-filled credentialing applications for payer approval to see their members (non-delegated credentialing).

Having complete and accurate information in Medallion makes it easier and faster to submit these applications.

Create your account and password

To start your onboarding with Foodsmart, you'll receive an invitation to your personal email from the Medallion system to create an account/profile.

Follow the instructions in the email to create a password and click sign up (remember your password - you'll need this throughout your time with Foodsmart).

‼️Please review your Medallion Profile to make sure the following information is added to complete your profile ⬇️

CDR Certificate: Current CDR (CDR Number, Effective Date, Expiration Date) - Both primary and subspecialty certifications with the CDR
CAQH Profile: CAQH profile completed, dated and attested to and imported into Medallion
State Licensure:
- State license in the primary state of residence
- All current, past, and pending licensure (License State, Number, Effective Date, and Expiration Date)
  - Illinois pending licenses require supporting documentation of submission - application copy or receipt of payment and attestation statement of date the application was mailed)
Basic Information: Name, DOB, SSN, Gender, NPI number, CAQH ID, Permanent Address
Education:
- Undergraduate and/or Graduate Education related to Dietetics/Nutrition (School Name, Address, Start Date, End Date, Program Type)
- Dietetic Internship (School Name, Address, Start Date, End Date, Program Type)
Work History: Work history dating back to undergraduate/graduate education:
- Oregon: Explanations required for gaps greater than 60 days
- Illinois: Explanations required for gaps greater than 30 days
- Other States: Explanations required for gaps greater than 6 months
- “Academic/Training Leave” not an acceptable gap explanation
- All gaps must have an explanation (eg. Cannot list “Other” with no additional information, or say “Unemployed”)

Integrate your CAQH profile

To expedite the process of completing your Medallion profile, enter your

CAQH ID
SSN
Last name

Click Integrate CAQH Account

Attest to your CAQH data and then confirm

After completing these steps, Medallion will start integrating with CAQH to update your profile

Once the integration is complete, go through your profile from the beginning and fill out each section as outlined below

All items outlined in red are required. Many boxes will say optional next to them. Please disregard this as it’s a product flaw.

⭐ Important:

If you have ever legally changed your name, you will be required to upload documentation for the name change

Note where you were born and select Save & Next

Please do not skip this step, birth Country, City and State are required.

⚠️ Warning:

Your Medallion profile must be 100% complete and linked to your CAQH profile in order to be approved by our credentialing committee to be scheduled for visits with patients.

⭐ Important:

Attestations need to be renewed every 120 days. Log into Medallion at least monthly to review your profile and complete any outstanding tasks so your profile is always 100% complete.

Continue updating your profile with additional information

Education
Training - add your Dietetic Internship information here
Work History - please explain any gaps longer than 30 days
Military Service
References - this section is noted as optional in Medallion but most payers do require 3 peer references for their applications

💡 TIP:

Licensure exam information is not required, you may skip this

Existing Licenses

In addition to a CDR, RDs must hold an active license in at least one state (as outlined in your contract with Foodsmart). An active or pending license must be added to Medallion to complete your profile.

Please upload copies of all current licenses with expiration dates

Please NOTE:

If your state license application has been submitted but not yet approved - you will add it to Medallion as a PENDING license to complete your profile.

Make a copy of the first page of your license application and upload that document in lieu of your license certificate.

Certifications

Add your CDR information and a copy of your CDR card

💡 TIP:

Existing Payers & CE Credits sections are not required, you may skip these

External Accounts

Add your CAQH account here. Enter your username, password and CAQH ID

Most Medicaid Provider Enrollment and payer credentialing applications require references to be included.

Update Medallion with 3 peer references - this step is noted as optional in Medallion but this is a requirement for foodsmart so your profile is as complete as possible.

Documents

Any documents that you have uploaded thus far will populate in the Documents section. Other documents you are required to add include

Professional diploma
Copies of state licensure (License Copy)
CDR card or certificate (add as Board Certification Diploma)
Resume/CV
Copy of your driver's license

Disclosure Questions

Please answer the disclosure questions and once completed, review and sign your agreement

Confirmation of a Completed Profile

When your profile is 100% complete, this is what you'll see at the bottom of your profile and you are DONE!!

✅

⚠️Please note:If there are any missing pieces, this is what you'll see. Review the required fields and complete with required information

✖️

⭐ Important:

When adding or updating a license in Medallion - be sure to select the correct LICENSE TYPE. RD-Registered Dietitian is the only type that should be selected. Other types such as OTHER or NUTRITIONIST will not correctly reflect in our systems or reports and may cause problems with scheduling patients in those states.

It is very important that you review your Medallion profile regularly to ensure it accurately reflects licensure and credentials. Patient visits cannot be scheduled with you in states where you don't show a valid license.

As you apply for and get approved for licenses in new states, add the information to your Medallion profile as soon as possible. If Foodsmart is reimbursing you for the cost of any license you obtain, your Medallion profile will be the receipt for that reimbursement.

Add a New License to your Profile in Medallion

Log in using your credentials and choose Existing Licenses from your profile

Select Add Existing License
Click Submit

Enter the required information to update Medallion with your new license

Status: Active
Include your license number
Add the issue date and expiration date
Upload a copy of your license
Click Submit

Follow these steps to change a pending license to active once it's issued

Log in using your credentials and choose Existing Licenses from your profile

Select your Illinois PENDING license
Change the status from PENDING to ACTIVE
- Update with the license number you were issued
- Add the issue date and expiration date
- Upload a copy of your license
Click Submit

⚠️ Warning:

💡 TIP:

It is a best practice to review your Medallion profile regularly to be sure it accurately reflects your licenses

You will not be scheduled to see patients in any state with an expired license!

When you receive notification from any state that a Provider Enrollment Application has been approved, you must add it to Medallion for it to register in our systems.

Follow these instructions to update your profile and store your Medicaid ID #