Common use of Dentist Credentialing and Selection Clause in Contracts

Dentist Credentialing and Selection. To the extent that MA Plan has delegated the credentialing process to Dentist, Dentist shall expeditiously credential dental care practitioners providing services on behalf of Dentist, in compliance with applicable laws and with the standards and requirements of the MA Plan and appropriate licensing, regulatory and accrediting agencies, including NCQA (to the extent applicable to services rendered under this Agreement) and the applicable State regulatory agencies. MA Plan shall have the right upon reasonable notice to review and monitor Dentist’s policies and procedures, including all documentation describing the credentials of dental care professionals providing services in connection with this Agreement. Further, MA Plan retains the right to audit the credentialing process on an ongoing basis and to revoke such delegation. As part of the credentialing process, Dentist shall obtain certification from each dental care professional providing the services listed above that such individual or entity has not been excluded from participation under Medicare nor has opted out of Medicare. In the event that Dentist has the responsibility or authority under this Agreement to select providers, or subcontractors to provide Covered Services, directly or indirectly, to MA Members, MA Plan retains the right to approve, suspend or terminate any such responsibility or authority. Dentist warrants that Dentist, and all dental care practitioners, including employees, contractors and agents of Dentist, who provide Covered Services to MA Members, shall be at all times during the term hereof, properly licensed by the state in which such services are rendered, certified, qualified and in good standing in accord with all applicable local, state and federal laws. Dentist and each of its sites shall be accredited, if applicable. Dentist, Dentist’s sites and all providers furnishing services hereunder shall meet applicable requirements and be properly certified under the Medicare programs, as set forth in Title XVIII of the Social Security Act. Upon request, Dentist shall provide satisfactory documentary evidence of such licensure, certification, and qualifications of Dentist, Dentist’s sites and physicians or other dental care providers furnishing services at Dentist’s sites.