Senate Bill 1291 Summary

• Amends Arizona's health insurer provider credentialing requirements to streamline the credentialing and loading process, including modifications to timelines and application procedures.

• Reduces credentialing completion timeline from unspecified to 60 calendar days and loading timeline from 100 to 130 calendar days after receipt of a complete credentialing application.

• Establishes that providers may receive in-network payment for covered services rendered from the date of complete application notification until contract execution, provided credentials are approved and contract is fully executed before claim submission.

• Requires health insurers to provide written disclosure to patients before service delivery stating the provider is not credentialed and not a contracted provider.

• Limits health insurers to tolling the credentialing timeline a maximum of three times while requesting additional information, with automatic application withdrawal possible after 30 days without response.