Lawmakers in Pennsylvania are attempting to change the credentialing process for health practitioners to address delays by insurers for inclusion in their networks. The state House Health Committee recently approved legislation to address the issue.
House Bill 533, would require all health insurers in Pennsylvania to accept The Council for Affordable Quality Healthcare’s (CAQH) credentialing application or another nationally recognized credentialing application designated by the Insurance Department. Health insurers would then have 45 days to complete the credentialing process after receiving the application.
At nCred we regularly witness slow processing times of credentialing applications of providers all over the country. It is admirable that the state introduce such legislation, but it will be interesting to follow implementation of the 45 day rule. Until insurance networks are required to accept provider information in a standard electronic format similar to the electronic format of claims that is defined by federal regulation, it will be difficult to improve insurance companies credentialing processes and turnaround times.