Find out what rights you and your patients have under current federal statutes and regulations, such as the Employee Retirement Income Security Act and the Medicare Advantage program.
Protecting patients and improving the accuracy of provider directory information
Balance billing in cases of emergency services; Balance billing in cases of non-emergency services performed by nonparticipating providers at certain participating facilities; Provider requirements with respect to disclosure on patient protections against balance billing; Enforcement; Air ambulance services; Provision of information upon request and for scheduled appointments; Patient-provider dispute resolution; Continuity of care; Provider requirements to protect patients and improve the accuracy of provider directory information
Protecting patients and improving the accuracy of provider directory information
Protecting patients and improving the accuracy of provider directory information
General; Definitions; Network Adequacy Standards; Network Access Plan Standards; Coordination and Continuity of Care; Network Access Plan Disclosures; Attestations; Provider Directories
Information to Prospective and Current Contract Holders and Enrollees
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
Notice requirements
Provider Directory Requirements for Network Adequacy
Certification of network plans