Common use of IMPLICATIONS OF DELEGATED CREDENTIALING Clause in Contracts

IMPLICATIONS OF DELEGATED CREDENTIALING. In some instances, the MCO credentials the individual provider directly or delegates credentialing of the providers to the following entities: - A subcontractor providing specific services (e.g., behavioral health or dental care); - A credentialing subcontractor; or - A facility (e.g., a freestanding clinic or hospital) The relationship between the MCO and the delegated entity as well as the interplay with various credentialing requirements may take any number of configurations. Currently, the Department reiterates that the MCO may delegate credentialing of individual providers to a facility (e.g., a school based health center, freestanding clinic or hospital). However, the Department emphasizes that the MCO is ultimately responsible and accountable to DSS for compliance with all of the Department's credentialing requirements.

IMPLICATIONS OF DELEGATED CREDENTIALING. In some instances, the MCO credentials the individual provider directly or delegates credentialing of the providers to the following entities: - · A subcontractor providing specific services (e.g., behavioral health or dental care); - · A credentialing subcontractor; or - · A facility (e.g., a freestanding clinic or hospital) The relationship between the MCO and the delegated entity as well as the interplay with various credentialing requirements may take any number of configurations. Currently, the Department reiterates that the MCO may delegate credentialing of individual providers to a facility (e.g., a school based health center, freestanding clinic or hospital). However, the Department emphasizes that the MCO is ultimately responsible and accountable to DSS for compliance with all of the Department's credentialing requirements.

IMPLICATIONS OF DELEGATED CREDENTIALING. In some instances, the MCO credentials the individual provider directly or delegates credentialing of the providers to the following entities: - • A subcontractor providing specific services (e.g., behavioral health or dental care); - • A credentialing subcontractor; or - • A facility (e.g., a freestanding clinic or hospital) The relationship between the MCO and the delegated entity as well as the interplay with various credentialing requirements may take any number of configurations. Currently, the Department reiterates that the MCO may delegate credentialing of individual providers to a facility (e.g., a school based health center, freestanding clinic or hospital). However, the Department emphasizes that the MCO is ultimately responsible and accountable to DSS for compliance with all of the Department's credentialing requirements.