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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Sources: Contract for Administrative Services Organization for Specialty Mental Health and Drug Medi Cal Substance Abuse Services, Contract for Administrative Services Organization for Specialty Mental Health and Drug Medi Cal Substance Abuse Services, Contract for Administrative Services Organization for Specialty Mental Health and Drug Medi Cal Substance Abuse Services
NETWORK PROVIDER CREDENTIALING. 33 a. CONTRACTOR and ADMINISTRATOR shall work together on credentialing 34 Network Providers in accordance with State guidelines which include, but are not limited to, verifying 35 the following information. Unless otherwise specified, primary source verification of information shall 36 be required. Primary source verification means confirmation and evidence from the issuing source or 37 designated monitoring entity of the requested information.
1 1) A current valid license to practice as an independent mental health practitioner;
2 2) A valid DEA certificate for physicians (primary source not required);
3 3) Graduation from an accredited professional school and/or highest training program 4 applicable to the academic degree, discipline, and licensure of the mental health practitioner which is 5 verified through license verification;
6 4) Board certification if the practitioner states that he/she is board certified on the 7 application;
8 5) Work history (primary source not required);
9 6) Current, adequate malpractice insurance in accordance with the Indemnification 10 and Insurance Paragraph of the Contract;
11 7) History of professional liability claims; and
12 8) Information from recognized monitoring organizations regarding the applicant’s 13 sanctions or limitations of licensure from:
14 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; andData
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