Provider Credentialing Update

Provider Credentialing Update

Starting June 11, 2020, providers will be required to submit credentialing applications to a single credentialing database, ProviderSource.

In an effort to reduce administrative burdens for health care providers in Washington, the legislature passed Second Substitute House Bill 2335 in 2016, which required providers to submit credentialing applications to a single credentialing database. The Office of the Insurance Commissioner (OIC) selected the organization OneHealthPort to develop a uniform electronic process for collecting and transmitting provider-supplied data to support credentialing and other related processes. OneHealthPort developed ProviderSource, which is a free online data collection and verification system that allows providers to manage their provider data used for credentialing.

Health carriers are required to accept and manage credentialing applications from the same database. As of June 1, 2020, this legislation requires that health carriers must make a determination approving or denying a credentialing application submitted to the carrier no later than 90 days after receiving a complete application. And, a health carrier’s average response to approve or deny a provider’s credentialing application may not exceed 60 days. 

This session, the legislature built upon the 2016 legislation by passing Engrossed House Bill (EHB) 1552. EHB 1552 states that health carriers may not require a provider to submit credentialing information in any format other than the database selected by the OIC, ProviderSource.

The new law takes effect June 11, 2020.

For more information on ProviderSource and how to register, visit OneHealthPort: Credentialing.

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