Ama Policy

Managed Care Insurance Company Credentialing H-285.979


The AMA:

(1) supports the development and utilization by all health insurance plans and managed care organizations of both a uniform application form and a reapplication form;

(2) will work with the centralized credentialing collection services established by state and county medical societies to implement the acceptance of uniform application and reapplication forms;

(3) urges managed care organizations to recredential participating physicians no more frequently than every two years;

(4) urges hospitals, managed care organizations and insurance companies to utilize state and county central credentialing services, where available, for purposes of credentialing plan physician applicants, and will identify all state and county central credentialing services and make this information available to all interested parties including hospital and managed care/physician credentialing committees;

(5) supports state and county medical society initiatives to promulgate a uniform reappointment cycle for hospitals and managed care plans; and

(6) opposes any legislative or regulatory initiative to mandate accreditation for CVOs by the NCQA or any other agency until a fair, equitable, reasonable and appropriately inclusive process for such accreditation exists.

Policy Timeline

Sub. Res. 703, A-94 Amended in lieu of Res. 705, I-94 Amended by Res. 716, I-96 Reaffirmed: Res. 809, I-02 Reaffirmed: CMS Rep. 4, A-12, Reaffirmed: CMS Rep. 4, A-12