Rhode Island General Laws 27-20.9-2. Credentialing – Insurers shall notify providers of initial credentialing within ten business days of approval by the insurer credentialing committee
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The health insurer shall reimburse the healthcare provider for covered services rendered by the healthcare provider to the health insurer’s subscribers or members following the first business day after the credentialing committee’s approval, provided that the healthcare provider returns a signed healthcare contract within fifteen (15) business days of receipt from the health insurer.
History of Section.
P.L. 2007, ch. 86, § 1; P.L. 2007, ch. 215, § 1.
Terms Used In Rhode Island General Laws 27-20.9-2
- Contract: A legal written agreement that becomes binding when signed.
- Health insurer: means every nonprofit medical service corporation, hospital service corporation, health maintenance organization, or other insurer offering and/or insuring health services; the term shall in addition include any entity defined as an insurer under § 42-62-4 and any third-party administrator when interacting with healthcare providers and enrollees on behalf of such an insurer. See Rhode Island General Laws 27-20.9-1
- Healthcare provider: means a person licensed or certified in this state to practice medicine, pharmacy, chiropractic, nursing, physical therapy, podiatry, dentistry, optometry, occupational therapy, or other healing arts. See Rhode Island General Laws 27-20.9-1