VA SB 1154

Title: Health insurance; online credentialing system, processing of new applications.
Author: Taylor Montgomery Mason

Summary
Health insurance; provider credentialing; processing of new applications. Requires a health insurance carrier that credentials the physicians, mental health professionals, or other providers in its network to establish reasonable protocols and procedures for processing of new provider credentialing applications. The bill requires that if the carrier accepts applications through an online credentialing system, the carrier is required to notify a new provider applicant through the online credentialing system that the application is received. The bill provides that if the carrier does not accept applications through an online credentialing system, the carrier is required to within 10 days of receiving an application provide notification to the new provider applicant that the application was received. The bill requires that, beginning January 1, 2024, a new provider applicant's application will be deemed complete within 30 days of the carrier receiving the application, unless the carrier has provided notice that the application is not complete. The bill requires a carrier to approve or deny new provider applicant credentialing applications within 60 days of receiving a completed application and provides that claims submitted according to carrier claims submittal policies are adjudicated and paid no later than 40 days after the new provider applicant is credentialed and contracted.

Status
House: Read second time

Bill Documents
VA SB 1154 - Committee substitute printed 23105129D-S1

VA SB 1154 - Prefiled and ordered printed; offered 01/11/23 23102836D

VA SB 1154 - Senate committee, floor amendments and substitutes offered

Add To Favorites

State Legislate

Federal Legislate

VA SB 1154