_________________________________________________________
Credentialing and Re-credentialing __________________________________________________________
Physician and Ancillary Provider Credentialing and Re-credentialing
Hometown Health is committed to providing our members with the highest quality of care available . As part of fulfilling this commitment , Hometown Health requires the providers requesting participation in its provider network to meet our stringent credentialing requirements that were created in accordance with CMS and URAC guidelines , as well other applicable federal and state regulations .
The credentialing and re-credentialing processes establish the requirements for the qualifications and appropriate licensure of providers , as well as requirements for professional conduct , access and availability of care , clinical documentation , and the provision of quality care to our members .
Hometown Health utilizes the standardized credentialing / re-credentialing application as implemented by State of Nevada Division of Insurance . In order to facilitate a more streamlined credentialing process , Hometown Health follows the three-year re-credentialing cycle as accepted by most major healthcare organizations in northern Nevada .
Providers requesting participation in the Hometown Health provider network must fully complete the credentialing application , sign and date the application and attestation , and provide the requisite documentation in a timely manner . Failure to comply with all aspects of the credentialing / re-credentialing process , or offering false or misleading information , will result in denial of participation and termination of contract , and other actions as mandated by federal , state , accreditation , or other regulatory statutes .
Providers applying for participation in the Hometown Health provider network have the following rights regarding the credentialing / re-credentialing process :
• The right to review the information submitted to support the provider ’ s credentialing application ;
• To correct erroneous information ; and
• To be informed of the status of the provider ’ s credentialing / re-credentialing application . To check the status , please call the Hometown Health Credentialing Department at ( 775 ) 982-3017 .
64