Provider Credentialing

THE STATE OF NEW HAMPSHIRE INSURANCE DEPARTMENT 21 Soum FRUlT STREET SunE 14 CONCORD, NEW HAMPSHIRE 03301 Christopher R. Nicolopoulos Commissioner David J. Bettencourt Deputy Commissioner Bulletin Docket No: INS 21-025-AB To: All Health Carriers From: Commissioner Christopher R. Nicolopoulos, Esq. Date: April 26, 2021 Re: Provider Credentialing The Department has been made aware that some health care providers are experiencing significant delays with respect to completing the credentialing process. The purpose of this bulletin is to remind health carriers of their responsibilities during the credentialing process. Health carriers are required to have written policies and procedures for credentialing verification in accordance with RSA 420-J:4(a). The Department would like to remind health carriers that they are required to finalize the credentialing process within 30 days of receiving a complete application for a primary care provider and 45 days for a specialist. RSA 420-J:4, I(h). If the provider submits an incomplete application, the health carrier must notify the health care provider of any deficiencies within 15 business days of receiving a credentialing application. RSA 420-J:4, I(g). The Department would like to encourage health carriers to work closely with health care providers to ensure that health care providers are provided with all relevant information in a timely manner and that the credentialing process is completed within the statutory time period. Health care providers experiencing difficulties or delays in completing the credentialing process are encouraged to file a complaint with Consumer Services using the Health Care Provider Complaint Form. The Department will be tracking all health care provider complaints relating to credentialing in order to determine whether regulatory action may be necessary. TELEPHONE 603-271-2261 • FAX 603-271-1406 • TDD Acrnss RELAY NH 1-800-735-2964 WEBSITE: www.nh.gov/insurance