Credentialing Standards

Recredentialing

Recredentialing Q&A – What You Need to Know

Q: How often are practitioners recredentialed? A: Practitioners and facilities are typically recredentialed every three years unless a state or health plan has different requirements. It is important to recredential practitioners and facilities in order to verify their ability to continue providing the services for which they are contracted. Q: What preparation is needed to …

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credentialing committee meeting

Best Practices for Credentialing Committee Meeting Management

As you probably already know, NCQA requires health plans to meet periodically to make credentialing decisions about network practitioners. During this process, known as a committee meeting, outside experts will determine whether providers should continue to be credentialed for the network. These regular meetings are critical for health plans’ compliance, but many plans struggle when …

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