Search Results
Ama Policy
03/13/2019
Credentialing-Due Process-Denial of Contract, Profiling, U.R. Criteria
Ama Policy
03/13/2019
Credentialing-Due Process-Denial of Contract, Termination, Termination-Due Process
Ama Policy
03/13/2019
Credentialing-Due Process-Denial of Contract, Termination-Due Process
ARC Advocacy Resources
Imposes deadlines within which a health insurer must process a complete credentialing application: thirty (30) days for primary care physicians and forty-five (45) days for other specialists. The model bill also states that credentialing due to economic factors must be adjusted to take into account the case mix, age, severity of illness, etc., and that during the credentialing process, health insurers must pay the physician for providing services to subscribers.
Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Credentialing-Patient Demographics, Credentialing-Payment Issues, Model Legislation
Ama Policy
10/15/2019
Credentialing-Due Process-Denial of Contract
Ama Policy
10/15/2019
Credentialing-Due Process-Denial of Contract
State Law
09/17/2021
Maine
Section 4303
Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Credentialing-Payment Issues, Fee Schedules, Most Favored Nation, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Prohibited financial incentives, Retroactive Denial, Termination, Termination-Due Process
State Law
12/03/2020
Maine
Sections 1-10
Purpose; Authority; Applicability and Scope; Affordable Care Act; Definitions; Quality Assurance Standards; Access to Services; Adverse Health Care Treatment Decisions; Grievance Register and Grievance Procedures; Reporting Requirements; Effective Date
Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Network Adequacy, Retroactive Denial, State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines, U.R. Criteria
State Law
03/20/2021
Michigan
Section 500.3531
Contracts with health care providers to become affiliated providers; requirements; standards; filing; duplicative standards; notice procedures; provider application period; approval or rejection as affiliated provider; termination of contract; providing information to insurer.
Credentialing-Due Process-Denial of Contract
State Law
07/13/2020
Nebraska
Section 44-4109.01
Policies or contracts; requirements
Credentialing-Due Process-Denial of Contract, Credentialing-Patient Demographics, Termination-Due Process
