HB 863 Summary

• Establishes the "Prompt Credentialing Act" requiring health carriers to use a uniform credentialing form that includes commonly requested information for health care professionals.

• Health carriers must acknowledge receipt of completed applications within 48 hours if sent electronically or within 5 business days if sent by mail, with electronic notification required when available.

• Health carriers must complete credentialing verification and make a final determination within 60 calendar days of receiving a completed application without material mistakes.

• Health carriers must retroactively compensate health care professionals for services rendered from the date of their application once credentialing is completed.

• Claims submitted by health care professionals after the 60-day period expires are subject to the provisions of section 376.383.