For Healthcare Providers

PrinterEmail

News

Providers' Rights during the Credentialing Process

Recent News


When Midlands Choice credentialing coordinators process a provider's initial or renewal application, they obtain and evaluate information from different sources.  As a current or prospective Midlands Choice provider, you have rights that are granted to you as the applicant through national credentialing standards such as URAC or the National Committee for Quality Assurance (NCQA).

As a provider, you have the right to review the information Midlands Choice gathers during the application processing, to ask about the status of your application while it is in process, and to correct any information submitted by another party you feel is incorrect.  You may also review information that has been obtained from outside primary sources such as malpractice insurance carriers or state licensing boards. By law, Midlands Choice is not allowed to release information submitted to the National Practitioner Data Bank, or information that is considered to be peer-review protected.  Review of application information is conducted in the offices of Midlands Choice by appointment.

If Midlands Choice receives information during the credentialing process that varies significantly from information submitted on the application, you will be provided an opportunity to explain the discrepancy. Discrepancies may include actions on a license, disciplinary actions, malpractice claims history, hospital privilege restrictions or terminations, and board certification status.

To contact the Midlands Choice credentialing office, email credential@midlandschoice.com or call 1-800-605-8259, ext. 7254.