Health insurance; credentialing, health care or professional health-related services.

Health insurance; credentialing; health care providers.Requires health insurers and other carriers that credential certain healthprofessionals in their provider networks to establish reasonable protocols andprocedures for reimbursing such a professional who has submitted a completedcredentialing application to a carrier, within 15 days of being credentialed bythe carrier, for services provided to covered persons during the period inwhich the applicant's completed credentialing application is pending. The billmakes this requirement applicable to a person, corporation, facility, orinstitution licensed by the Commonwealth to provide health care or professionalservices as a physician or hospital, dentist, pharmacist, registered nurse orlicensed practical nurse or person who holds a multistate privilege to practicesuch nursing under the Nurse Licensure Compact, nurse practitioner,optometrist, podiatrist, physician assistant, chiropractor, physical therapist,physical therapy assistant, clinical psychologist, clinical social worker,professional counselor, licensed marriage and family therapist, licensed dentalhygienist, health maintenance organization, or emergency medical care attendantor technician who provides services on a fee basis. Such a requirement existsin current law for participating physicians and participating mental healthprofessionals but without a time limit for reimbursement. The bill applies the15-day limit to such participating physicians and participating mental healthprofessionals.