TMA Offers Guide for New Credentialing Law

From the Mid-South MGMA:

New legislation that impacts the insurance credentialing process for physicians goes into effect January 1, 2016. A new TMA resource provides a helpful guide to the new law. For several years, the TMA advocated for passage of legislation that would permit physicians going through the credentialing process with health plans to be reimbursed for services provided to those health plan members during the credentialing process.

The rationale was that at least 99% of physicians are eventually credentialed with health plans, but the process can take several weeks, even months, to complete. Practices overwhelmingly expressed that they would gladly risk having to reimburse the plan if their physician was not eventually credentialed. In 2015, legislation passed to address this situation. TMA has created a comprehensive guide to the new law. The TMA legal department also produced this video to explain the new law, which can be found here.