New Hampshire Revised Statutes 420-J:8-c – Reimbursement for Providers Waiting for Health Carrier Credentialing Verification
Current as of: 2023 | Check for updates
|
Other versions
I. Pursuant to N.H. Rev. Stat. § 420-J:4, I, health carriers issuing health benefit plans subject to this chapter shall pay claims for covered services rendered to covered persons by a health care provider who, at the time of submission of a clean and complete credentialing application, has a valid license from the respective state licensing board and has been credentialed by the hospital, if appropriate. The claim for covered services rendered by the provider applicant shall be paid at the same contracted rate as the credentialed provider:
(a) When covering on-call for another health care provider who is credentialed by the carrier and billed using the name of the credentialed provider; or
(b) Who, at the time of application, is credentialed by the health carrier in another state or is in the health carrier’s New Hampshire network based on employment with a particular health care entity.
II. For purposes of N.H. Rev. Stat. § 420-J:4 and this section, a health care provider having a valid license shall include all:
(a) Mental health practitioners licensed under N.H. Rev. Stat. Chapter 330-A and applicants for mental health practice licensure from other states who are permitted to practice in this state pursuant to N.H. Rev. Stat. § 330-A:26, II.
(b) Psychologists licensed under N.H. Rev. Stat. Chapter 329-B and psychologists licensed in another jurisdiction issued a temporary license to practice under N.H. Rev. Stat. § 329-B:20, III.
(a) When covering on-call for another health care provider who is credentialed by the carrier and billed using the name of the credentialed provider; or
Terms Used In New Hampshire Revised Statutes 420-J:8-c
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- state: when applied to different parts of the United States, may extend to and include the District of Columbia and the several territories, so called; and the words "United States" shall include said district and territories. See New Hampshire Revised Statutes 21:4
(b) Who, at the time of application, is credentialed by the health carrier in another state or is in the health carrier’s New Hampshire network based on employment with a particular health care entity.
II. For purposes of N.H. Rev. Stat. § 420-J:4 and this section, a health care provider having a valid license shall include all:
(a) Mental health practitioners licensed under N.H. Rev. Stat. Chapter 330-A and applicants for mental health practice licensure from other states who are permitted to practice in this state pursuant to N.H. Rev. Stat. § 330-A:26, II.
(b) Psychologists licensed under N.H. Rev. Stat. Chapter 329-B and psychologists licensed in another jurisdiction issued a temporary license to practice under N.H. Rev. Stat. § 329-B:20, III.