Credentialing Criteria. Provider and each Contracted Provider shall complete Company’s and/or Payor’s credentialing and/or recredentialing process as required by Company’s and/or Payor’s credentialing Policies, and shall at all times during the term of this Agreement meet all of Company’s and/or Payor’s credentialing criteria. Provider and each Contracted Provider represents, warrants and agrees: (a) that it is currently, and for the duration of this Agreement shall remain: (i) in compliance with all applicable Regulatory Requirements, including licensing laws; (ii) if applicable, accredited by The Joint Commission or the American Osteopathic Association; and (iii) a Medicare participating provider under the federal Medicare program or eligible to enroll as a Medicare participating provider under the federal Medicare program and a Medicaid participating provider under applicable federal and State laws; and (b) that all Contracted Providers and all employees and contractors thereof will perform their duties in accordance with all Regulatory Requirements, as well as applicable national, State and local standards of professional ethics and practice. No Contracted Provider shall provide Covered Services to Covered Persons or identify itself as a Participating Provider unless and until the Contracted Provider has been notified, in writing, by Company that such Contracted Provider has successfully completed Company’s credentialing process.
Credentialing Criteria. Each Hospital shall (a) currently, and for the duration of this Agreement, remain accredited by the Joint Commission or American Osteopathic Association, as applicable; and (b) ensure that all employees of Hospital perform their duties in accordance with all applicable local, State and federal licensing requirements and standards of professional ethics and practice.
Credentialing Criteria. After School Services
Credentialing Criteria. Behavior Management Services
Credentialing Criteria. Each Hospital shall: (a) currently, and for the duration of this
Credentialing Criteria. IPA's written credentialing policies must:
a. Include minimum criteria for credentialing health care providers, as well as the circumstances under which exceptions, if any, may be made;
b. Designate the person(s) responsible for conducting credentialing activities and for seeking approval of clinical personnel;
c. Establish a Credentialing or Quality Assessment Committee responsible for credentialing decisions;
d. Define time frames and procedures for recredentialing, which must occur at least every two years; and
e. Require the review of the credentialing policies by the IPA's governing body at predetermined intervals.
Credentialing Criteria. Support Staff
1. Qualifications Must be a minimum of 21 years of age, which will be verified and have at least three years (36 months) of paid work experience consistent with age and need of the child or youth. A current resume and a current Statement of Experience is required. Demonstrated experience working with children within the last 5 years. Special Requirements for all Staff: Proof of age and education. A valid Connecticut motor vehicle license, current motor vehicle certificate of insurance, Copy of Diploma from highest education attained, First Aid and CPR certificates issued by a nationally recognized accredited organization are required. Interns: The use of interns and volunteers in this position is strictly prohibited, but they can be used to perform other duties under the supervision of the Provider.
2. Ethics The Provider will sign the Department's Confidentiality Statement and Ethics Agreement.
Credentialing Criteria. The Corporation's Joint Policy ---------------------- Committee shall, from time to time, establish uniform credentialing criteria applicable to all physician-employees in order to properly evaluate the performance of such physician-employee, including Physician. This uniform credentialing criteria shall include, without limitation, such factors as the licensing of a physician, the good standing of a physician with payors, and the continuing medical education taken by a physician. Additionally, the Corporation's Joint Policy Committee shall establish uniform criteria in the following areas for the purpose of evaluating the performance of all physician- employees, including Physician, and in order to compile the data necessary to compete for, and comply with, managed care contracts: (i) utilization review; (ii) practice parameters, and (iii) outcome analysis.
Credentialing Criteria. Therapeutic Support Staff
Credentialing Criteria. “Credentialing Criteria” means criteria which may be established by a Payor, IGS or third party for the credentialing and re-credentialing of Participating Providers, and which may be amended by them from time to time.
