Credentialing verification definition

Credentialing verification means the process of obtaining and verifying information about a health professional and evaluating the health professional when the health professional applies to become a participating provider with a health maintenance organization.
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Credentialing verification means the process of obtaining and verifying information about a health professional and evaluating that health professional when that health professional applies to become a participating provider with a health maintenance organization.
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Credentialing verification means the process of obtaining and verifying information about a health care provider sufficient to determine if the provider can be enrolled as a participating provider in the Medicaid program.
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Examples of Credentialing verification in a sentence

  • Credentialing verification is conducted, as part of the renewal process to ensure the information furnished by the Provider is complete, current and accurate.

  • Credentialing verification requirements for providers of non-Depart- ment of Veterans Affairs health care services.Sec.

  • Credentialing verification is conducted to ensure the information furnished by the Provider is complete, current, and accurate.

  • Is on behalf of a provider who does not have accounts receivable 19 with the department; 20 (b) "Credentialing application date" means the date that a credentialing 21 verification organization receives a clean application from a provider; 22 (c) "Credentialing verification organization" means an organization that gathers 23 data and verifies the credentials of providers in a manner consistent with 24 federal and state laws and the requirements of the National Committee for 25 Quality Assurance[.

  • Notice of termination of the engagement of the rabbi should be given in accordance with the requirements of the parties’ agreement.

  • The elements are: • License to practice.• Drug Enforcement Agency registration.• Medical Board sanctions.• Education and training.• Malpractice claims history.• Medicaid/Medicare sanctions.• Work history.• Practitioner application processing.• Credentialing verification organization application and attestation content.• Ongoing monitoring.

  • Credentialing verification reveals that there are no issues to report to the Credentials Committee.

  • Is on behalf of a provider who does not have accounts receivable with the department; (b) "Credentialing application date" means the date that a credentialing verification organization receives a clean application from a provider; (c) "Credentialing verification organization" means an organization that gathers data and verifies the credentials of providers in a manner consistent with federal and state laws and the requirements of the National Committee for Quality Assurance.

  • Is on behalf of a provider who does not have accounts receivable 10 with the department; 11 (b) "Credentialing application date" means the date that a credentialing 12 verification organization receives a clean application from a provider; 13 (c) "Credentialing verification organization" means an organization that gathers 14 data and verifies the credentials of providers in a manner consistent with 15 federal and state laws and the requirements of the National Committee for 16 Quality Assurance.

  • CREDENTIALING OF PRACTITIONERS: Credentialing verification for all employed and contracted practitioners is performed by GHC-SCW.


More Definitions of Credentialing verification

Credentialing verification means the process of
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Related to Credentialing verification

  • 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.

  • Independent Verification means that an evaluation is undertaken and reported by an individual or body whose organisation, systems and procedures conform to ISO Guide 65:1996 (EN 45011:1998) General requirements for bodies operating product certification systems (as amended form time to time) or equivalent, and who is accredited to audit against forest management standards by a body whose organisation, systems and procedures conform to ISO 17011: 2004 General Requirements for Providing Assessment and Accreditation of Conformity Assessment Bodies (as amended from time to time) or equivalent.

  • Verification means the process of comparing sets of data to establish the validity of a claimed identity (one-to-one check);

  • Busy Line Verification (BLV) means a service whereby an End User requests an operator to confirm the busy status of a line.

  • CEC Certification and Verification means that the CEC has certified (or, with respect to periods before the Project has commenced commercial operation (as such term is defined by and according to the CEC), that the CEC has pre-certified) that the Project is an ERR for purposes of the California Renewables Portfolio Standard and that all Energy produced by the Project qualifies as generation from an ERR for purposes of the Project.

  • STATUS VERIFICATION SYSTEM This “Status Verification System” requirement, also referred to as “E-Verify”, only applies to contracts issued through a Request for Proposal process and to sole sources that are included within a Request for Proposal.

  • 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).

  • Verification system means the system maintained by the department under section 19-24.1-31 for verification of registry identification cards.

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

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

  • 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;

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

  • Verification Report As defined in Section 4.19.

  • 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.

  • Busy Line Verification (BLV means a service whereby an End User requests an operator to confirm the busy status of a line.

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

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

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Clinical review criteria means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services.

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Root Cause Analysis Report means a report addressing a problem or non-conformance, in order to get to the ‘root cause’ of the problem, which thereby assists in correcting or eliminating the cause, and prevent the problem from recurring.

  • Electronic Subcontracting Reporting System (eSRS) means the Governmentwide, electronic, web-based system for small business subcontracting program reporting. The eSRS is located at http://www.esrs.gov.

  • 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.

  • Validation as used in WAC 222-20-016, means the department's agreement that a small forest landowner has correctly identified and classified resources, and satisfactorily completed a roads assessment for the geographic area described in Step 1 of a long-term application.

  • 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.

  • Clinical nurse specialist means a registered nurse with relevant post-basic qualifications and 12 months’ experience working in the clinical area of his/her specified post-basic qualification, or a minimum of four years’ post-basic registration experience, including three years’ experience in the relevant specialist field and who satisfies the local criteria.