Third-Party Payer Credentialing
The American Academy of Family Physicians (AAFP) supports a single, nationally standardized health care professional credentialing application as one way to support administrative simplification.
The AAFP believes that payers:
- who require board certification as a requirement should permit physician participation for residents who have evidence of completing the required training and are actively pursuing meeting the requirements for board certification;
- should make final physician credentialing determinations within 45 calendar days of receipt of a completed application;
- should grant provisional credentialing, pending a final credentialing determination, if the credentialing process exceeds 45 calendar days;
- should provide an electronic means for the physician to track the application;
- should retroactively compensate physicians for services rendered from the receipt date of physicians’ completed credentialing application upon final, successful credentialing determination;
- should provide an electronic copy of the fee schedule to the provider upon being successfully credentialed.
(2007) (2017 COD)