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MO SB526
Bill
AI Summary
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Establishes the "Prompt Credentialing Act" requiring health carriers to credential health care professionals using a uniform application format that includes commonly requested information.
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Mandates health carriers complete the credentialing verification process and make a final determination within 60 calendar days of receiving a completed application.
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Requires health carriers to retroactively compensate health care professionals for services rendered from the date of their application once they become credentialed.
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Defines key terms including "completed application" (submitted on uniform form with no omitted required information), "credentialing" (assessment of qualifications based on license, training, competence, and ability to perform requested privileges), and cross-references existing definitions for "health benefit plan" and "health carrier" from section 376.1350.
Legislative Description
Requires health carriers to credential health care professionals within 60 calendar days of receipt of complete application
Last Action
Second Read and Referred S Small Business, Insurance and Industry Committee
1/5/2012