Common use of Credentialing and Re-credentialing Clause in Contracts

Credentialing and Re-credentialing. The Contractor shall credential Providers, except as provided in Section 2.8.8.4, in accordance with NCQA credentialing standards as well as applicable HFS, DHS, DoA, Illinois Department of Insurance and federal requirements. Re-credentialing shall occur every three (3) years. At re-credentialing and on a continuing basis, the Contractor shall verify minimum credentialing requirements and monitor Enrollee Complaints and Appeals, quality of care and quality of service events, and medical record review.

Credentialing and Re-credentialing. The Contractor shall credential Providers, except as provided in Section 2.8.8.45.7.5, in accordance with NCQA National Committee for Quality Assurance (NCQA) credentialing standards as well as applicable HFS, DHS, DoA, Illinois Department of Insurance and federal requirements. Re-credentialing shall occur every three (3) years. At re-re- credentialing and on a continuing basis, the Contractor shall verify minimum credentialing requirements and monitor Enrollee Complaints and Appeals, quality of care and quality of service events, and medical record review.

Credentialing and Re-credentialing. The Contractor shall credential Providers, except as provided in Section 2.8.8.4, Providers in accordance with NCQA National Committee for Quality Assurance (NCQA) credentialing standards as well as applicable HFS, DHS, DoA, Illinois Department of Insurance and federal requirements. Re-credentialing shall occur every three (3) years. At re-credentialing and on a continuing basisin between credentialing cycles, the Contractor shall verify minimum credentialing requirements and monitor Enrollee Complaints and Appeals, quality of care and quality of service events, and medical record review.

Credentialing and Re-credentialing. The Contractor shall credential Providers, except as provided in Section 2.8.8.4, Providers in accordance with NCQA credentialing standards as well as applicable HFS, DHS, DoAIDoA, Illinois Department of Insurance Insurance, and federal requirements. Re-Re- credentialing shall occur every three (3) years. At re-credentialing and on a continuing basis, the Contractor shall verify minimum credentialing requirements and monitor Enrollee Complaints and Appeals, quality of quality-of-care and quality of quality-of- service events, and medical record review.. Contractor shall document its process for credentialing and re-credentialing Providers.‌‌

Credentialing and Re-credentialing. The Contractor shall credential Providers, except as provided in Section 2.8.8.42.8.10.3, in accordance with NCQA credentialing standards as well as applicable HFS, DHS, DoA, Illinois Department of Insurance and federal requirements. Re-credentialing shall occur every three (3) years. At re-credentialing and on a continuing basis, the Contractor shall verify minimum credentialing requirements and monitor Enrollee Complaints and Appeals, quality of care and quality of service events, and medical record review.