Claim History Wizard for 3rd Party Requestors

Quick Reference Guide

Duration: 6:24

This is a video walk through of how to obtain a claim history from the wizard.

Transcript

Welcome to the CRICO Underwriting Training Series. This video features information about how to submit a Claims History/Loss Run Request via our online Claim History Wizard for 3^rd Party Requestors.

The Claim History Wizard allows non-CRICO organizations to request claims histories from CRICO directly.

• Please Note: a $25 administrative fee is applicable for requesting claim histories on behalf of individuals who are no longer insured by CRICO. The charge applies to individuals who are no longer in the CRICO program.

• For all third party requests we require a release form that has been signed/dated within the last 6 months by the practitioner. If you do not have a release form, there is a downloadable template on the claim history request page that we will accept.

To Begin:

1. Google “CRICO” and click on the link, or enter www.rmf.harvard.edu into your web browser.

2. Navigate to Contact Us from the About tab at the top of the page and then click Claims History Request.
   
   OR

3. Find the wizard by selecting one of the following:

   • Scroll down to the Contact Us link at the bottom left-hand side of the homepage, and then click Claims History Request.
   • Navigate to the Claim History Wizard by clicking the CLAIMS HISTORY request here icon in the center of the CRICO homepage,

   • Enter www.rmf.harvard.edu/claimshistory to start the request.

4. Choose the corresponding option for the clinician, either Currently CRICO Insured, or No longer insured by CRICO. For this training video we will use the ‘No Longer Insured’ button in our example.

As a 3rd party requesting a claims history for a provider, we will now walk through the process

1. There are two options for a Third Party Administrator to proceed. Indicate whether a claim history is being requested for a physician (MD, DDS, DPM, DMD, DO) or an employee (this includes all allied health professionals: technicians, assistants, technologists; general nursing: RN, LPN; advanced practice clinicians: CNP, PA, CRNA, CNM; as well as psychologists, LICSW and PhD). Click on the applicable button and you will be directed to an online request form.

2. Fill out all required fields indicated by a red asterisk*

   1. All third party requests require a waiver form authorizing the release of information signed by the clinician. Authorizations need to be signed and dated within the last 6 months.

   2. There is a sample release form on the page, you can click to download a release form if you don’t have one of your own.

   3. If there is not an option to upload a release form, you have not selected the correct options on the first screen. You can hit the Back button on your browser and change your selections.

   4. When completing the form, indicate if the claim history should be sent to a State Board of Licensing/Licensure by entering the two letter state code in the corresponding field. Please include contact information at the state board or any special instructions in the ‘Note to Underwriting Section.’

      Note: BORM’s Malpractice History Waiver for Release of Information is still required. Forms are available by logging onto BORM’s website. The physician may also write this waiver themselves.

3. Bulk Requests: You can submit additional requests by providing the same required information for all additional clinicians in the Bulk Requests section. Please separate each name by semicolons. A signed release form is required for each individual.

4. If your request is urgent, please use the Note to Underwriting section to let us know any additional information you would like to share about the request, such as urgency, or an address you would like the request to be mailed to.

5. Confirm that you have the necessary authorization to obtain a claim history on behalf of a CRICO insured provider and verify the recipient email address by checking the box in the Confirmation and Follow-Up Section.

6. Click Submit.

   1. You will receive a confirmation email indicating that your request has been received and will be processed within 5 business days.

   2. Please Note: a $25 administrative fee is applicable for requesting claim histories on behalf of individuals who are no longer insured by CRICO. The charge applies to individuals who are no longer in the CRICO program.

   3. If payment is required, you will be directed to the PayPal page to submit payment (which we will discuss in more detail later in this video). Once payment has been submitted, you will receive a receipt email from PayPal for your records. If you have paid for your request, you will receive 2 emails from CRICO: 1) a confirmation that we received your request and 2) a receipt of payment. If your request does not require payment, you will only receive 1 email.

   4. Once Underwriting has secured and reviewed all documentation, and verified payment (if required) the claims history will be prepared and sent within five business days of payment.

   5. Please keep in mind that duplicate requests and follow ups can cause delays and reduce service times for claims history requests.

PayPal

• All electronic payments for claims histories are processed through PayPal. PayPal accepts a large number of major credit cards, including Visa, MasterCard, American Express, Discover, JCB, Diner’s Club and EnRoute.

• A PayPal account is not required for payment transactions. Requestors who do not have a PayPal account and do not wish to create an account may submit their payments through PayPal via a guest transaction.

• If PayPal is not accepting the credit card information that you are providing, you may contact PayPal customer service at 888-221-1161.

• If you do not wish to pay the $25 processing fee with a credit card, you can elect to connect your company’s corporate bank account to its PayPal account. In order to do this, you must submit your company’s bank account number and routing number. Once the bank account is linked to PayPal and you are prompted to pay the $25 processing fee, the fee will be deducted from your PayPal account in a single transaction.

• If neither of these options work for you please contact Underwriting at [email protected] or 617.450.8219.