Recredentialing definition

Recredentialing or being “recredentialed” means the
Recredentialing means to confirm that a participating provider is in good standing by a health insurer or its designee and does not require submitting an application or going through a contracting and loading process.
Recredentialing means the process by which a credentials verification entity verifies the credentials of a health care practitioner whose core credentials data, including all corrections, updates, and modifications thereto, are currently on file with the entity.

Examples of Recredentialing in a sentence

  • Recredentialing must be completed within 36 months of prior credentialing or recredentialing activity (as required by CMS & DMHC).

  • Blue Shield shall be entitled to conduct audits of Group’s compliance with the criteria and standards of Delegated Credentialing and Recredentialing.

  • Recredentialing must be completed within 36 months of prior credentialing or recredentialing activity.

  • Recredentialing must be completed within 24 months of prior credentialing or recredentialing activity.

  • Recredentialing Primary source verification (PSV) Delegated Meet 90% of all NCQA Recredentialing standards (except PSV of Licenser).

  • Recredentialing - A process for the periodic reverification of clinical credentials (recredentialing, reappointment, or recertification) is described in the organization's policies and procedures.

  • Include list of all providers recredentialed on a quarterly basis (with quarterly report) • Annual audit of files of 5% or random sample of 50 to represent entire contracted network • Annual onsite assessment Recredentialing to include: License, clinical privileges, DEA/CDS, Board Certification, Malpractice insurance, Professional Liability claims, signed Attestation regarding any inability to perform and lack of present illegal drug use.

  • The Contractor shall conduct Credentialing and Recredentialing in compliance with 907 KAR 1:672 and federal law.

  • Recredentialing to include: License, clinical privileges, DEA/CDS, Board Certification, Malpractice Insurance, Professional Liability claims, signed Attestation regarding any inability to perform and lack of present illegal drug use.

  • Recredentialing Sanction information ý Delegated o Not delegated Full compliance with NCQA Recredentialing Standards regarding verification of information within 180 days prior to Committee approval date.


More Definitions of Recredentialing

Recredentialing means the verification and reverification of all education, licenses, certificates, insurance and liability or claims history to support the qualifications of any Healthcare Provider.

Related to Recredentialing

  • 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.

  • Credentials means the unique log-in identifier entered via the Cloud Portal by which a person could access the Cloud Program.

  • Credential means a valid credential, life diploma, permit, or document in special education or pupil personnel services issued by, or under the jurisdiction of, the State Board of Education if issued prior to 1970 or the California Commission on Teacher Credentialing, which entitles the holder thereof to perform services for which certification qualifications are required as defined in Title 5 of the California Code of Regulations section 3001(g).

  • Audiology means the care and services provided by a licensed audiologist as set forth in the member state’s statutes and rules.

  • Specialist Physician means a licensed physician who qualifies as an attending physician and who examines a patient at the request of the attending physician or authorized nurse practitioner to aid in evaluation of disability, diagnosis, or provide temporary specialized treatment. A specialist physician may provide specialized treatment for the compensable injury or illness and give advice or an opinion regarding the treatment being rendered, or considered, for a patient’s compensable injury.

  • Provider Manual means a working document, including but not limited to BCBSM published bulletins and provider notices, that provide specific guidelines and direction by which providers may meet their contractual responsibility as described in this Agreement. Provider Manuals are published on web-DENIS.

  • Screening means the evaluation process used to identify an individual's ability to perform activities of daily living and address health and safety concerns.

  • Quality Management System means a set of interrelated or interacting elements that organisations use to direct and control how quality policies are implemented and quality objectives are achieved;

  • Login Credentials means any passwords, authentication keys, or security credentials that enable Customer’s access, management to the Service Offering, or both.

  • Training means instruction or teaching designed to impart a specific skill, as opposed to general knowledge.

  • Audiologist means an individual who is licensed by a state to practice audiology.

  • Roster ’ means a list of persons quali- fied to provide services as neutrals.

  • Service Complaints For service problems or complaints, you should contact your local utility by calling: AEP Ohio at 000.000.0000. IN THE EVENT OF AN ENERGY-RELATED EMERGENCY, SUCH AS A POWER OUTAGE OR DOWNED POWER LINE, PLEASE VACATE THE AREA BY A SAFE DISTANCE AND CALL YOUR LOCAL UTILITY or 911. Authorization/Representation/Letter of Agency:By entering into this Agreement, you authorize XOOM to act on your behalf under your local utility’s tariffs in accordance with the rules and regulations of the PUCO. You acknowledge that you are your local utility account holder, or a person legally authorized to execute this Agreement on behalf of the account holder for electricity service and are at least eighteen (18) years of age. You agree to authorize XOOM to obtain your credit information and you agree to authorize your local utility to release all information relating to your historical and current electricity usage, billing and payment history to XOOM or its authorized representatives. You acknowledge that XOOM has full authority to make all rates and tariff selections necessary to meet its obligations under this Agreement. You may rescind this authorization at any time by contacting XOOM. Neither your social security number, customer account number nor any other customer financial information will be released by XOOM, except where such release is required by court order or by Commission Order or Rule, without your affirmative written consent. Execution of this Agreement shall constitute authorization for the release of this information to XOOM.

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Quality Assurance Program means the overall quality program and associated activities including the Department’s Quality Assurance, Design-Builder Quality Control, the Contract’s quality requirements for design and construction to assure compliance with Department Specifications and procedures.

  • Investigators means those persons authorised, appointed, consulted or approached by the Chairman of the Audit Committee and includes the Auditors of the Company and the Police.

  • Specialist means either a physician or other health care professional who practices in a specific area other than those practiced by primary care providers, or a properly licensed, certified or registered individual health care provider whose practice is limited to rendering mental health services. For purposes of cost-share, this definition of “specialist” does not apply to dentists. BCBSAZ does not require you to obtain an authorization or referral to see a specialist.

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Training provider means an organization meeting the eligibility conditions as mentioned in Data Sheet and selected in accordance with the criteria set forth for the purpose.

  • Testing means that element of inspection that determines the properties or elements, including functional operation of materials, equipment, or their components, by the application of established scientific principles and procedures.

  • Architectural services means those services described as the "practice of architecture," as defined in K.S.A. 74-7003, and amendments thereto.

  • Laboratory or “LANL” means the geographical location of Los Alamos National Laboratory, a federally funded research and development center owned by the DOE / NNSA.

  • Credentialed Evaluator For purposes of this policy, each teacher subject to evaluation will be evaluated by a person who:

  • Medical Specialist means any medical practitioner who is vocationally registered by the Medical Council under the Health Practitioners Competence Assurance Act 2003 in one of the approved branches of medicine and who is employed in either that branch of medicine or in a similar capacity with minimal oversight.

  • ODJFS means the Ohio Department of Job and Family Services.

  • Provider of health care means a physician or physician assistant licensed pursuant to chapter 630, 630A or 633 of NRS, perfusionist, dentist, licensed nurse, dispensing optician, optometrist, practitioner of respiratory care, registered physical therapist, podiatric physician, licensed psychologist, licensed audiologist, licensed speech-language pathologist, licensed hearing aid specialist, licensed marriage and family therapist, licensed clinical professional counselor, chiropractor, licensed dietitian or doctor of Oriental medicine in any form.