SB 526 - This act requires every health carrier that credentials health care professionals in a health benefit plan to request credentialing information in a uniform format that includes data commonly requested by health carriers for the purpose of credentialing. "Credentialing" is defined as the process of assessing and validating the qualifications of a health care professional to provide patient care services. The determination is based on an evaluation of the individual's current license, training or experience, current competence, and ability to perform the privileges requested. Every health carrier shall complete the process of verifying a health care professional's credentialing information and make a final determination to credential the health care professional within sixty calendar days of receipt of a complete application.
Immediately after a health care professional becomes credentialed, every health carrier shall retroactively compensate health care professionals for services rendered from the date of his or her application.
This act is identical to SB 215 (2011).
ADRIANE CROUSE