Common use of Credentialing Requirements Clause in Contracts

Credentialing Requirements. In order to become a Represented Provider, each provider may be required to submit to Anthem BC&BS a Credentialing Application. The Provider Credentialing Applications submitted by or on behalf of each Represented Provider are expressly incorporated by reference into this Agreement. The CONTRACTING PROVIDER and each Represented Provider represent and warrant that the information set forth therein is true and correct. Anthem BC&BS's approval of a Represented Provider's Credentialing application and its determination of his/her/its compliance and CONTRACTING PROVIDER's compliance with Anthem BC&B S's applicable standards, if any, as they may be amended by Anthem BC&BS from time to time, are conditions precedent to this Agreement. CONTRACTING PROVIDER shall be subject to, and CONTRACTING PROVIDER shall cooperate with, ReCredentialing on a periodic basis. Such processes include, but are not limited to, medical records audits, office site surveys, patient satisfaction surveys and physician practice profiling. Anthem BC&BS shall determine in its sole discretion whether to approve Represented Provider's continued participation upon ReCredentialing. Such approval may be conditioned upon compliance with specific limitations or corrective actions. Within thirty (30) business days of extending an offer to employ, contract or associate with a provider, CONTRACTING PROVIDER shall submit a Credentialing application to Anthem BC&BS consistent with this Section 3.1 and this Agreement. In no event shall such provider provide any Covered Services to Members, including coverage of CONTRACTING PROVIDER, until such provider is credentialed and certified by Anthem BC&BS, except as Anthem BC&BS may otherwise direct. CONTRACTING PROVIDER shall notify Anthem BC&BS in writing within ten (10) days of any material change in the information set forth in any Represented Provider's Credentialing application or ReCredentialing application.

Credentialing Requirements. In order to become a Represented Provider, each provider may be required to must submit to Anthem BC&BS a Credentialing Application. The Provider Credentialing Applications submitted by or on behalf of each Represented Provider are expressly incorporated by reference into this Agreement. The CONTRACTING PROVIDER and each Represented Provider represent and warrant that the information set forth therein is true and correct. Anthem BC&BS's approval of a Represented Provider's Credentialing application and its determination of his/her/its her compliance and CONTRACTING PROVIDER's compliance with Anthem BC&B SBC&BS's applicable standards, if any, as they may be amended by Anthem BC&BS from time to time, time providing they are generally consistent with National Committee for Quality Assurance (NCQA) standards. are conditions precedent to this Agreement. CONTRACTING PROVIDER shall be subject to, and CONTRACTING PROVIDER shall cooperate with, ReCredentialing Re-Credentialing on a periodic basis. Such processes include, but are not limited to, medical records audits, office site surveys, patient satisfaction surveys and physician practice profiling. Anthem BC&BS shall determine in its sole discretion whether to approve Represented Provider's continued participation upon ReCredentialingRe-Credentialing. Such approval may be conditioned upon compliance with specific limitations or corrective actions. Within thirty (30) business days of extending an offer to employ, contract or associate with a provider, CONTRACTING PROVIDER shall submit a Credentialing application to Anthem BC&BS consistent with this Section 3.1 4.1 and this Agreement. CONTRACTING PROVIDER shall notify Anthem BC&BS in writing within ten (10) days of any material change in the information set forth in any Represented Provider's Credentialing application or Re-Credentialing application. In no event shall such provider provide any Covered Services to Members, including coverage of CONTRACTING PROVIDER, until such provider is credentialed and certified by Anthem BC&BS, except as Anthem BC&BS may otherwise direct. CONTRACTING PROVIDER shall notify Anthem BC&BS in writing within ten (10) days of any material change in the information set forth in any Represented Provider's Credentialing application or ReCredentialing application.