The credentialing department evaluates the qualifications of providers who wish to become affiliated with Network Health. The credentialing process plays a vital role in providing safe, quality patient care to our members.
Availability of Provider Directories Changes
Clinician Data Maintenance and Credentialing Requirements
Credentialing Committee Membership and Responsibility
Credentialing and Recredentialing Process Policy
Credentials and Recredentialing Information Collection, Coordination and Dissemination
Credentialing and Recredentialing Information Integrity, Confidentiality and Auditing of Credentialing Data
Cultural Competency Interpreter Education
Delegation and Oversight Policy and Procedure
Fair Hearing Review Process
Initial and Ongoing Assessment of Organizational Providers
Medicare Opt Out
Non-Quantitative Treatment Limitation (NQTL)
Process of Ongoing Monitoring of Sanction, Complaints, Adverse Events and Quality Issues
Provider Data Validation
Provider Directory Compliance
Range of Actions to Improve Performance/Altering the Conditions of Participation
Reporting to the Proper Authorities
Site Visit and Medical Record Keeping Practices
Phone: 920-720-1790 or 844-295-9214
Fax: 920-720-1853