Credentialing Program Clause Samples
The Credentialing Program clause establishes the requirements and procedures for verifying the qualifications and competencies of individuals or entities involved in providing services under the agreement. Typically, this clause outlines the standards that must be met, the documentation required, and the process for initial and ongoing credential verification. For example, it may require service providers to submit proof of licenses, certifications, or background checks before commencing work. The core function of this clause is to ensure that only qualified and vetted personnel are engaged, thereby reducing risk and maintaining quality standards.
Credentialing Program. Provide administrative support to Practice as necessary to obtain and verify credentialing information in accordance with applicable laws, standards and Practice requirements, including but not limited to the following activities:
6.1 Prepare Credentialing Policies and Procedures;
6.2 Provide administrative support to all credentialing activities;
6.3 Obtain primary source verification;
6.4 Prepare applicable documentation;
6.5 Set up provider credentialing file and follow-up of credentialing documents.
Credentialing Program. Provider agrees to meet and maintain NCQA and/or established industry standards for Provider credentialing adopted by the Avesis Credentialing Program as well as any other requirements that may be imposed by the Sponsor, from time to time. These include, but are not limited to, current licensure; current certifications, as appropriate; professional liability insurance coverage; compliance with continuing education requirements; and such other requirements and qualifications as may be required by Avesis, Sponsor or any State or Federal agency. Failure to cooperate with the credentialing or recredentialing process may result in payment for services rendered being withheld until all recredentialing materials have been received by Avesis. Provider further agrees to notify Avesis of subsequent changes in status of any information relating to Provider’s professional credentials. None of Avesis’ or Sponsor’s utilization management, quality management, credentials verification or provider sanction programs shall either a) override the professional or ethical responsibility of the provider or b) interfere with the provider’s ability to provide information or assistance to members.
Credentialing Program. Participating Provider agrees to meet and maintain NCQA and/or established industry standards for Participating Provider credentialing adopted by the Avesis Credentialing Program as well as any other requirements that may be imposed by the Sponsor, from time to time. These include, but are not limited to, current licensure; current certifications, as appropriate; professional liability insurance coverage; compliance with continuing education requirements; and such other requirements and qualifications as may be required by Avesis, Sponsor or any State or Federal agency. Failure to cooperate with the credentialing or recredentialing process may result in payment for services rendered being withheld until all recredentialing materials have been received by Avesis. Participating Provider further agrees to notify Avesis of subsequent changes in status of any information relating to Participating Provider’s professional credentials. None of Avesis’ or Sponsor’s utilization management, quality management, credentials verification or provider sanction programs shall either a) override the professional or ethical responsibility of the provider or b) interfere with the provider’s ability to provide information or assistance to members.
Credentialing Program. Provider agrees to adhere to all of the requirements established by the Avesis Credentialing Program. Avesis credentialing process can be found in the Avesis Provider Manual.
Credentialing Program in demonstration of compliance with credentialing and recredentialing requirements specified under this agreement and applicable federal and state statue and regulation, delegate shall maintain an infrastructure to support credentialing activities, including a designated credentialing committee, and shall maintain policies and procedures that describe at minimum, the following: A. The types of CS Providers subject to credentialing and recredentialing; B. The verification sources used; C. The criteria for credentialing and recredentialing; D. The process for making credentialing and recredentialing decisions; E. The process for managing credentialing files that meet established criteria; F. The process for sub-delegating credentialing or recredentialing (as applicable); G. The process for ensuring that credentialing and recredentialing are conducted in a non-discriminatory manner; and H. The process for ensuring CS Providers are notified of the credentialing and recredentialing decision within 60 calendar days of the credentialing committee decision.
Credentialing Program. Practitioner shall participate with and cooperate in VBH’ credentialing program, including all applicable laws, licensure requirements, and standards of professional conduct, and represents and warrants that all information submitted to VBH in connection with such credentialing program is true, complete and accurate. Practitioner shall notify VBH immediately of any material change in such information. In the event Practitioner discovers that a claim, suit, criminal or administrative proceeding has been brought against Practitioner relating to the quality of services provided to Members or relating to Practitioner's compliance with community standards and applicable laws and regulations, then Practitioner shall notify VBH of such claims, suit or proceeding within five (5) working days. Practitioner understands that this Agreement may be terminated, or his/her participation in VBH’ programs may be suspended, for any failure to be in continuous compliance with VBH' credentialing standards.
Credentialing Program. Participating Provider agrees to meet and maintain NCQA and/or established industry standards for provider credentialing established by the Avesis Credentialing Program as well as any other requirements that may be imposed by the Sponsor, from time to time. These include, but are not limited to, current licensure; current certifications, as appropriate; professional liability insurance coverage; compliance with continuing education requirements; and such other requirements and qualifications as may be required by Avesis, Sponsor or any State or Federal agency.
Credentialing Program. Provider shall submit to HNFS or its designee any applicable credentials application or re-credentialing application that meets minimum requirements of HNFS. In no event will this Agreement be executed by HNFS, nor will Provider or any Professional Provider or subcontractor begin performing or continue to perform, as applicable, Provider's obligations under this Agreement, until Provider and/or such Professional Provider and/or such Facility has satisfied applicable credentialing or re-credentialing requirements, if any. Failure to submit re-credentialing materials may, at HNFS’s option, subject the Professional Provider to suspension or termination under this Agreement, or termination of this Agreement in its entirety.
Credentialing Program. Provider shall submit to Health Net or its designee any applicable vetting or Credentialing Application, which meets minimum requirements of Health Net. Provider or subcontractor shall not begin performing Provider’s obligations under this Agreement, until Provider and/or Facility has satisfied applicable vetting or credentialing or re-credentialing requirements, if any.