• 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)