7/27/2023
At three-year intervals, Midlands Choice recredentials providers and facilities to verify that criteria for participation continue to be met. If there is no response to requests for recredentialing by the third anniversary of the last credentialing date, the provider’s participation with Midlands Choice is terminated.
Effective immediately, when a provider who was terminated due to non-response to requests for recredentialing submits their recredentialing application after the termination date, the provider will be assigned a new Midlands Choice effective date based on when the recredentialing application is approved. Due to this lapse in participation, claims for the provider submitted for dates of service incurred between the termination date and the new effective date will process as non-participating.