Credentialing Criteria definition

Credentialing Criteria means Health Plan’s criteria for the credentialing or re- credentialing of Providers.

Credentialing Criteria means Alliance’s criteria for the credentialing or re- credentialing of Providers.

Credentialing Criteria means the rules and regulations that govern BCBSMT’s Credentialing and Recredentialing process for the HELP Program. The applicable Credentialing and Recredentialing Criteria will be consistent with the applicable Montana and federal statutes, rules and regulations, including, without limit, the CMS Medicaid requirements for provider screening and enrollment requirements as outlined under 42 Code of Federal Regulations 455 Subpart E, including but not limited to disclosure of information regarding ownership and control, business transactions and persons convicted of crimes, site visits, criminal background checks, federal database checks, enrollment screening based on provider risk category (including unannounced pre and post site visits where applicable).

Examples of Credentialing Criteria in a sentence

• Credentialing Criteria – criteria establishing the qualifications of Network Providers.

• Contracted Provider and its subcontracted Providers shall secure and maintain for themselves and their employees, commercial general liability and professional liability (malpractice) insurance or self-insurance coverage for claims arising out of events occurring during the term of this Agreement and any post expiration or termination activities under this Agreement, in amounts required to meet Credentialing Criteria, and worker’s compensation insurance as required by State Laws.

• Dialectical Behavior Therapy Program (DBT) Credentialing Criteria for Individual Practitioners, Group Practice, or Organizational Provider-Based Professionals Credentialing criteria for individual practitionersSeveral licensure levels qualify individuals to serve Members, either in private practice, group practice, or in organizational providers settings (clinics, agencies, and/or hospitals), as distinguished from those who may practice in organizational providers only.

• Refer to Network Credentialing Criteria for details regarding satisfactory malpractice history.

• At December 31, 2020, if the currency had weakened/strengthened by 10% (2019: 10%) against the US dollar with all other variables held constant, post-tax profit for the year and equity would have been GH¢1,304,156 (2019: GH¢44,049) lower/higher, mainly as a result of US dollar denominated trade payables, receivables and cash and bank balances.

• A Staff member desiring additional privileges shall request them in writing addressed to the Chairman of the applicable Department, and shall provide such documentation of the Staff Member's qualifications as may be required by the Department's Credentialing Criteria or other applicable criteria or guidelines, or as requested by the Chairman.

• For more information, please see Policy 300-4030 Credentialing Criteria and Identified Issues..

• Sammons, Ph.D., ABPP dated November 15, 2016 representing the National Register of Health Service Psychologists: Credentialing Criteria and Guidelines which requested that the Board consider accepting the National Register's licensure mobility program as reciprocal licensing in Louisiana.

• Contractor shall conform and abide with all Facility Credentialing Criteria or Michigan Department of Community Health policy requirements.

• Health One, and its agents, reserves the right to require independent verification of any and all of the Credentialing Criteria.

More Definitions of Credentialing Criteria

Credentialing Criteria means the criteria established, from time to time, by KHF for the initial credentialing and re-credentialing (as needed and determined by the Board) of Participating Providers, which may be amended from time to time by KHF in its sole discretion.

Credentialing Criteria. Credentialing Criteria" means the criteria established by CHN for the initial credentialing and re-credentialing (every 3 years) of Participating Providers, which may be amended from time to time by CHN in its sole discretion. The Credentialing Criteria pertaining to Provider are set forth in EXHIBIT 2.12. All Providers must pass the CHN credentialing process prior to participation in any Plan of CHN PPO.

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.

Credentialing Criteria means the standards and processes for credentialing and/or recredentialing Affiliated Providers, as described in APS's Credentialing Activities, required for the accreditation of managed care organizations by NCQA or other recognized accrediting entity.

Credentialing Criteria means the criteria established by the IPA for the credentialing and recredentialing of Participating Providers, which may be amended from time to time by IPA in its sole discretion. (The Credentialing Criteria pertaining to Professional are set forth in Exhibit "B" hereto).