OK HB2217

Health benefit plans must credential or recredential physicians and other health care providers using uniform credentialing applications and must provide applicants with required materials checklists.

Plans must notify applicants within 10 calendar days if applications are incomplete, specifying what information or corrections are needed.

Plans must initiate primary source verification and malpractice history requests within 7 calendar days of deeming an application complete; malpractice carriers have 21 calendar days to respond or face administrative penalties.

Clean applications must be credentialed within 45 calendar days; non-clean applications may be extended 60 calendar days with certified mail notification, and the entire process cannot exceed 180 calendar days.

Within 31 days after a provider is credentialed, the health benefit plan must consider the provider in-network for reimbursement purposes; plans are prohibited from denying applications solely based on lack of board certification or from adding requirements to delay applications.