NETWORK PROVIDER CREDENTIALING Sample Clauses

The Network Provider Credentialing clause establishes the requirements and procedures for verifying the qualifications and professional standing of healthcare providers before they are allowed to participate in a health plan's network. Typically, this involves a thorough review of the provider’s education, licenses, certifications, work history, and any disciplinary actions, ensuring that only qualified professionals deliver care to plan members. By setting these standards, the clause helps maintain the quality and safety of healthcare services, protecting patients and the integrity of the network.
NETWORK PROVIDER CREDENTIALING a. CONTRACTOR and ADMINISTRATOR shall work together on credentialing Network Providers in accordance with State guidelines which include, but are not limited to, verifying the following information. Unless otherwise specified, primary source verification of information shall be required. Primary source verification means confirmation and evidence from the issuing source or designated monitoring entity of the requested information. 1) A current valid license to practice as an independent mental health practitioner; 2) A valid DEA certificate for physicians (primary source not required); 3) Graduation from an accredited professional school and/or highest training program applicable to the academic degree, discipline, and licensure of the mental health practitioner which is verified through license verification; 4) Board certification if the practitioner states that he/she is board certified on the application; 5) Work history (primary source not required); 6) Current, adequate malpractice insurance in accordance with the Indemnification and Insurance Paragraph of the Contract; 7) History of professional liability claims; and 8) Information from recognized monitoring organizations regarding the applicant’s sanctions or limitations of licensure from: a) State Board of Licensure or Certification and/or the National Practitioner Data Bank; b) State Board of Medical Examiners, the Federation of State Medical Boards, or appropriate agency; and
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NETWORK PROVIDER CREDENTIALING a. CONTRACTOR and ADMINISTRATOR shall work together on credentialing Network Providers in accordance with State guidelines which include, but are not limited to, verifying the following information. Unless otherwise specified, primary source verification of information shall be required. Primary source verification means confirmation and evidence from the issuing source or designated monitoring entity of the requested information. 1) A current valid license to practice as an independent mental health 2) A valid DEA certificate for physicians (primary source not required); 3) Graduation from an accredited professional school and/or highest training program applicable to the academic degree, discipline, and licensure of the mental health practitioner which is verified through license verification; 4) Board certification if the practitioner states that he/she is board certified on 5) Work history (primary source not required); 6) Current, adequate malpractice insurance in accordance with the Indemnification and Insurance Paragraph of the Contract;
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NETWORK PROVIDER CREDENTIALING. 25 a. CONTRACTOR shall be responsible for credentialing Network Providers in 26 accordance with State guidelines which include, but are not limited to, verifying the following 27 information. Unless otherwise specified, primary source verification of information shall be required.
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NETWORK PROVIDER CREDENTIALING. 7 a. CONTRACTOR shall be responsible for credentialing Network Providers in 8 accordance with State guidelines which include, but are not limited to, verifying the following
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NETWORK PROVIDER CREDENTIALING. 21 a. CONTRACTOR and ADMINISTRATOR shall work together on credentialing Network 22 Providers in accordance with State guidelines which include, but are not limited to, verifying the following 24 monitoring entity of the requested information. 25 1) A current valid license to practice as an independent mental health practitioner; 26 2) A valid DEA certificate for physicians (primary source not required);
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Related to NETWORK PROVIDER CREDENTIALING

  • Credentialing Firm shall be required to access Citizens’ online vendor credentialing system (“CAIS”) to input, update and maintain certain information about Firm and the persons who will perform work related to this Agreement (“Staff”), as provided below and in Exhibit B attached hereto.

  • PROVIDER PERSONNEL 1. The parties recognize that the primary value of the Provider to the Department derives directly from its Key Personnel assigned in the performance of this Agreement. Key Personnel are deemed to be those individuals whose résumés were offered by the Provider in the Proposal. Therefore, the parties agree that said Key Personnel shall be assigned in accordance with the time frames in the most recent mutually agreed upon project schedule and work plan, and that no re-deployment or replacement of any Key Personnel may be made without the prior written consent of the Agreement Administrator. Replacement of such personnel, if approved, shall be with personnel of equal or greater abilities and qualifications. 2. The Department shall retain the right to reject any of the Provider's employees whose abilities and qualifications, in the Department's judgment, are not appropriate for the performance of this Agreement. In considering the Provider's employees' abilities and qualifications, the Department shall act reasonably and in good faith. 3. During the course of this Agreement, the Department reserves the right to require the Provider to reassign or otherwise remove any of its employees found unacceptable by the Department. In considering the Provider's employees' acceptability, the Department shall act reasonably and in good faith. 4. In signing this Agreement, the Provider certifies to the best of its knowledge and belief that it, and all persons associated with this Agreement, including any Subcontractors, including persons or corporations who have critical influence on or control over this Agreement, are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any Federal or State department or agency. 5. During the course of this Agreement, the Department reserves the right to require a background check on any of the Provider’s personnel (employees and Subcontractors) that are in any way involved in the performance of this Agreement.

  • Provider Directory a. The Contractor shall make available in electronic form and, upon request, in paper form, the following information about its network providers: i. The provider’s name as well as any group affiliation; ii. Street address(es); iii. Telephone number(s); iv. Website URL, as appropriate; v. Specialty, as appropriate; vi. Whether the provider will accept new beneficiaries; vii. The provider’s cultural and linguistic capabilities, including languages (including American Sign Language) offered by the provider or a skilled medical interpreter at the provider’s office, and whether the provider has completed cultural competence training; and viii. Whether the provider’s office/facility has accommodations for people with physical disabilities, including offices, exam room(s) and equipment. b. The Contractor shall include the following provider types covered under this Agreement in the provider directory: i. Physicians, including specialists ii. Hospitals

  • Provider Services Charges for the following Services when ordered by a Physician for the treatment of an Injury or Illness.

  • Contract for Professional Services of Physicians Optometrists, and Registered Nurses