Maryland’s credentialing law is in § 15-112 of the Insurance Article. The statute deals with multiple aspects of how carriers contract with providers for participation on a provider panel. “Within 30 days of receiving an application, a carrier must send notice of the carrier’s intent to continue to process the application or a rejection of the application. If a carrier proceeds with processing the application, the carrier has 120 days after the date of the notice to accept or reject the provider for participation and send notice of the decision. If an application is incomplete, the carrier must return the application within 10 days.
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Section
15-112.1 of the Insurance Article requires a carrier to accept the uniform credentialing form submitted to it by a provider. A carrier may not request information that is not part of the uniform credentialing form. The Council for Affordable Quality Healthcare, Inc. (CAQH) online form has been designated as the uniform credentialing form.
It is always best to consult with an attorney if you have questions relating to signing a provider panel contract.
To file a complaint about credentialing delays or problems, you can use our
online system.
