Recently, Arizona State passed a bill (HB 2322) that will place some boundaries around the timing and quality of the credentialing process.
TTG’s team collaborates with many insurance carriers throughout the US. The provider representatives with the insurance carriers often have an enormous volume of physicians and facilities they are responsible for supporting. In spite of their best attempt to respond quickly, it’s clear they are typically over burdened with applications, inquiries and contracts. These important roles are just one of many critical aspects of the physician credentialing process. Just three years ago, TTG Healthcare Advisors were able to credential a facility or provider in less than 60 days. Now, the timelines in Arizona average 90 days with some contracts taking up to eight months to be approved and loaded.
Rep. Heather Carter (AZ), in conjunction with AZHHA, led the successful passing of a new bill that will reduce headache and timelines for the healthcare industry.
The new bill requires that all insurance carriers be prepared for a faster, and more communicative, process, effective January, 2019.
The below highlights the initial portion of the bill. The insurance companies will be required to:
Receive electronic submission of application.
Receive electronic versions of supporting documentation for application (or re-application).
A credentialing committee, of at least two members, will review the application. One member will be a Provider.
The application review must be completed within 60 days of the submission of a complete application.
The insurer must notify the applicant of approval, or denial, of an application, within seven days following the application review.
The contract must be loaded within 10 days after the conclusion of the credentialing process.
The bill further explains expedited timelines and communication regarding application status, denials, and initial information. All guidelines will make a dramatic improvement in the onboarding of facilities and providers.
The physician credentialing process is very complicated and requires a significant amount of tenacity, knowledge, and experience. Each insurance carrier has different regulations and submission processes change frequently. Avoid common pitfalls and delays of income. Engage a knowledgeable and relentless team. Read more about TTG's credentialing process.