Okla. Admin. Code § 310:657-3-2

Current through Vol. 42, No. 3, October 15, 2024

Section 310:657-3-2 - Credentialing responsibilities

(a) The Plan shall credential each provider under written policies, and shall complete credentialing before the provider's contract becomes effective. The Plan shall not list the provider in the provider directory or marketing materials until credentialed.

(b) The Plan shall establish a body of professional peers to review and approve the Plan's credentialing policies. A health professional designated by the Plan shall oversee credentialing.

(c) The Plan shall obtain proof of the applicant's current authority to practice a health profession. Proof shall be based on evidence from the source issuing the credential. The Plan shall retain all records and documents on a provider for at least five (5) years. Nothing in OAC 310:657-3 requires public disclosure of information which is confidential following applicable law.

(d) At least once every five (5) years, the Plan shall verify the professional's authority to practice.

Okla. Admin. Code § 310:657-3-2

Added at 12 Ok Reg 2977, eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok Reg 2404, eff 6-25-06