Terms Used In Arizona Laws > Title 20 > Chapter 27 - Provider Credentialing

• Applicant: means a provider that submits a credentialing application to a health insurer to become a participating provider in the health insurer's network. See Arizona Laws 20-3451
• Application: means an applicant's initial application to be credentialed as a participating provider. See Arizona Laws 20-3451
• Credentialing: means to collect, verify and assess whether a provider meets relevant licensing, education and training requirements to become or remain a participating provider. See Arizona Laws 20-3451
• Designee: means a third party to whom the health insurer has delegated credentialing activities or responsibilities. See Arizona Laws 20-3451
• Health insurer: means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or a hospital, medical, dental and optometric service corporation and includes the health insurer's designee. See Arizona Laws 20-3451
• Loading: means to input a participating provider's information into a health insurer's billing system for the purpose of processing claims and submitting reimbursement for covered services. See Arizona Laws 20-3451
• Participating provider: means a provider that has been credentialed by a health insurer or its designee to provide health care items or services to subscribers in at least one of the health insurer's provider networks. See Arizona Laws 20-3451
• Provider: means a physician, hospital or other person that is licensed in this state or that is otherwise authorized to furnish health care services in this state. See Arizona Laws 20-3451
• sent: means to deliver by United States mail, personal delivery or fax or by electronic means consistent with the requirements of section 20-239. See Arizona Laws 20-117
• Subscriber: means a person who is eligible to receive health care benefits pursuant to a health insurance policy or coverage issued or provided by a health insurer. See Arizona Laws 20-3451