Back to Chapter 9 Table of Contents
CH 9:
Credentialing & Recredentialing This Chapter Includes: Alert Alert draws attention to critical information that has changed this year.
1. Credentialing Scope 2. Provider Credentialing Application Requirements 3. Minimum Qualifications for Initial Credentialing
Contact Contact information on who to contact for assistance.
4. Specialized Participation as a PCP or Human Immuno deficiency Virus (HIV) Specialist 5. Provider Recredentialing
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6. Provider’s Right to Review and Correct Information 7. Right to Be Informed of Application Status 8. Right to Appeal Adverse Credentialing Determinations 9. Sanction Monitoring 10. Credentialing Committee 11. Submitting Provider Data for Delegated Independent Physician Association (IPA)/Provider Groups 12. Delegated Credentialing Requirements 13. Corrective Action Plans
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2021 / Provider Manual
CH 9: Credentialing & Recredentialing
