Before services begin, the provider panel must be credentialed. We would hope that the collaborative would establish clear time frames and processes with the MCO to assure that providers have adequate time to comply with the credentialing requirements and have mechanisms to expedite credentialing approvals when needed.
Providers can advance their system by beginning now to prepare their human resource files.
Documentation from accrediting bodies and malpractice insurance coverage are areas to be reviewed to ensure they are current. Organizational charts that clearly depict responsibilities, including supervisory responsibilities, must be prepared. Annual performance evaluations should be completed and available in the file. The collaborative should have a role in monitoring the MCO adherence to these limits. In the SE and SW, there have been problems with promptness of claims payment.