Credentialing definition

Credentialing means the process of assessing and validating the qualifications of a provider applying to be approved by a contracting entity to provide basic health care services, specialty health care services, or supplemental health care services to enrollees.

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Credentialing means the process of collecting, assessing, and validating qualifications and other relevant information pertaining to a health care provider to determine eligibility and to deliver Covered Services.

Credentialing means obtaining, verifying, and assessing the qualifications of a health practitioner to provide treatment, care, or services in or for a health facility.

Examples of Credentialing in a sentence

• Credentialing of BHT Supervising staff providing the service will need to be submitted on the first month of providing service.

• Contractor and Contractor representatives visiting or entering the San Mateo Medical Center (SMMC) main campus or any of its satellite clinics are required to register with SMMC’s Vendor Credentialing Program prior to conducting business onsite.

• This Policy applies to the CFSP and covers Credentialing and Re-credentialing policies for both individual and organizational providers.

• The process and information requirements shall meet the most current data and processing standards for a Credentialing process for an accredited health plan with accreditation from the selected, nationally recognized accrediting organization, and shall also meet the standards found in 42 C.F.R. Part 455 Subparts B and E.

• This Uniform Credentialing and Re-credentialing Policy outlines the expectations of the Department with regard to the Centralized Provider Enrollment and Credentialing Process and standards utilized by a CFSP in determining whether to allow a provider to be included in the CFSP’s network based upon the inclusion of a provider in the daily Provider Enrollment File, which signifies the provider has met the Department’s criteria as a Medicaid Enrolled provider.

More Definitions of Credentialing

Credentialing means the administrative process for reviewing, verifying, and evaluating the qualifications and credentials of licensed physicians, physician assistants and advanced practice registered nurses in accordance with criteria established by the nursing facility for the purpose of granting clinical privileges at the nursing facility.

Credentialing means a process through which a health insurer makes a determination based on criteria established by the health insurer concerning whether a physician, advanced registered nurse practitioner, or physician assistant is eligible to provide health care services to an insured and to receive reimbursement for the health care services provided under an agreement entered into between the physician, advanced registered nurse practitioner, or physician assistant and the health insurer.

Credentialing or "recredentialing" means:

Credentialing means the issuance of or approval by the Arkansas State Board of Pharmacy of a credential issued to a pharmacist by an agency approved by the board certifying that the pharmacist has met the standards of competency established by the Arkansas State Board of Pharmacy for disease state management or other pharmacy services necessitating a credential;

Credentialing means a clinical determination that is the responsibility of a physician medical director. It is the employer or affiliating organization’s responsibility to act on the clinical credentialing status of EMS personnel in making employment or deployment decisions.

Credentialing means the acts of an examining board, sec- tion of an examining board, affiliated credentialing board or the department that relate to granting, issuing, denying, limiting, sus- pending or revoking a credential.

Credentialing means the process through which an individual is