Frequently asked questions
What is credentialing?
Markel credentialing is providing the combination of proof of the insurance coverage history and any claims history for a medical provider while
covered under a Markel/Evanston insurance medical policy
What is needed to provide Markel credentialing verification?
- A provider name (please include the professional designation)
- A policy number (or reference the name of a locums/staffing organization if known)
- A signed release/authorization (this is mandatory)
- The requestor name and return email address (if not sent directly from the requesting entity)
What is the difference between credentialing and loss runs?
- A credentialing letter shows ONLY claims relevant to the requested provider. A loss run shows the ENTIRE claim history of the policy itself.
Please note that a policy loss run is to be released to select authorized representatives of the named policy only.
- To send a policy loss run to someone other than an authorized officer/representative of the named insured is a violation of the Markel
Who requests or needs a credentialing verification?
- Hospitals, clinics, medical offices, and government medical entities
- Locums or staffing organizations
- The provider themselves
- Agents, brokers, and producers
Why does credentialing occur?
- Hospitals, medical facilities, or other entities need to establish a history of the insurance coverage and any claims history of the provider for
their application process. This history requirement can be up to 10 years of proof.
- Brokers and agents need credentialing verification (coverage and claim histories) to quote new or renewal business for the provider.
Why should a COI not be used for proof of coverage?
- COIs are statements of general coverages for the named insured entity.
- They typically imply, rather than explicitly name, extended coverages to approved covered providers.
- COIs can imply coverage for a provider before or after actual coverage is present. COIs might be issued prior to or after the actual dates that
coverage is initiated, terminated, or performed via an approved contractual assignment.
- For proof of coverage, all covered providers should be confirmed either through being named on the COI with verifiable retro/start date (not
the policy retro date), or documented within the policy or file information.
- Markel’s credentialing verification provides the same policy information as a COI while being relative to the coverage status and including a
claims status for the specific individual provider.
How soon can you expect to get your verification returned to you?
Our turnover time is within 24–48 (business) hours. At times we are able to do this same day. Return times can be longer when/if we do not have ready access to the current dates of employment, assignment status or attendance dates for the provider. We may then need to reach out to other sources and our return to you will be dependent on their response back to us.