Common use of Credentialing and Recredentialing Clause in Contracts

Credentialing and Recredentialing. 2.1 By virtue of the PPO Agreement and this Addendum A, Ameritas hereby delegates to Dentist and Dentist agrees to perform the credentialing/ recredentialing functions for the Additional Providers in accordance with Ameritas’ credentialing or recredentialing requirements (“Ameritas Credentialing Policies”), as the same may be updated by Ameritas from time to time upon notice to Dentist. Notwithstanding such delegation, Ameritas retains the ultimate credentialing decision. Dentist shall maintain current and complete credentialing files for each of the Additional Providers as required by Ameritas Credentialing Policies. Dentist may further delegate all or any part of its credentialing responsibility to another party only with Ameritas’ prior written consent. 2.2 Dentist agrees that for the term of this PPO Agreement, all Additional Providers shall meet all requirements set forth in Ameritas Credentialing Policies. Upon request, Dentist shall promptly confirm the complete credentialing status of an Additional Provider in writing (if requested) and provide to Ameritas in a timely manner the information necessary for Ameritas to make a decision regarding the PPO network status of a particular Additional Provider. In the event an Additional Provider does not continue to meet the Ameritas Credentialing Policies, Dentist shall notify Ameritas as soon as reasonably possible after becoming aware of such noncompliance. Such Additional Provider shall immediately cease rendering services to Covered Persons. Notwithstanding anything herein or any subsequently adopted procedure to the contrary, Ameritas reserves the right to terminate, suspend, revoke, or reduce any Additional Provider’s participation in the Ameritas PPO as provided in Ameritas Credentialing Policies, and Dentist agrees to cooperate with Ameritas to implement the foregoing. 2.3 Dentist shall promptly notify Ameritas of any material change in the Dentist’s ability to perform delegated credentialing. Ameritas may withdraw the delegation set forth in this Addendum A at any time upon advance written notice to Dentist. 2.4 Ameritas is responsible for the oversight of its delegated credentialing functions. As such, Ameritas shall have the right to verify Dentist’s continuous compliance with Ameritas’ Credentialing Policies either through surveys to be completed by Dentist or otherwise require Dentist to submit periodic reports to Ameritas regarding the performance of its delegated credentialing responsibilities. Dentist agrees and shall cause its Additional Providers to agree to allow Ameritas or its agents or designees access, at least every three (3) years and upon at least ten (10) business days prior notice during normal business hours, to a random sample of complete credentialing files administered by Dentist on behalf of Ameritas.