Virginia legislators introduced a bill that would direct health plans to develop protocols to pay physicians for services performed once a credentialing application is received, instead of waiting until all the paperwork has been received and processed.
Here's what you should know.
1. Pennsylvania legislators introduced a similar proposal in 2015, which was tabled shortly thereafter, but introduced again in 2017.
2. ABC encourages all its clients to bring legislative attention to the bill, because of the multiple issues associated with delayed billing.
3. Specifically, the delay creates three issues:
- The amount of required information is fluid and expanding
- All though there is a standard credentialing form, not all organizations recognize it
- The processing time is growing, and applications are lost somewhat frequently, requiring the process to be restarted
4. The issue is relevant to every practice that brings on new physicians, as every missed step or required document, impedes the approval process.
5. Virginia House Bill 139 was nearly unanimously approved. It also passed the Senate Commerce and Labor Committee Feb. 26. It is pending in the Senate.
6. If it is signed into law, carriers would have to reimburse physicians for services rendered from the date their applications are received, at the same in-network rate as if they were already credentialed.