Credentialing; loading; timelines; exception

Processing applications of providers

Timely Credentialing of Physicians by Carriers – Notice of Receipt Required – Notice of Incomplete Applications Required – Delegated Credentialing Agreements – Discrepancies – Denials of Claims Prohibited – Disclosures – Recredentialing – Enforcement – Rules – Definitions

Definitions; Development and use of uniform health care and hospital credentials forms

Definitions; Permitted Disclosures by Providers; Coverage of Benefit or Service; Payment of Provider, Application; Provider Credentialing; Provider Directories; Preferred Provider Agreement Prohibitions; Insurer Payment to Insured for Service Rendered by Noncontracted Provider; Requirements; Fully Credentialed Provider Reimbursement; Requirements

Notice by managed care plan insurer of health care provider’s application for credentialing–Payments to applicant.