MN HF1992

Health plan companies must notify providers within two business days if a credentialing application is incomplete, specifying deficiencies or missing information.

Health plan companies must make a determination on complete ("clean") applications for provider credentialing within 30 days of receipt.

If a health plan company fails to make a determination within 30 days, the application is automatically deemed approved and the provider is authorized to provide health care services.

Health plan companies must pay clean claims submitted by auto-approved providers according to existing clean claim payment requirements in section 62Q.75.

These requirements apply to all credentialing applications submitted to health plan companies on or after August 1, 2019.