- A. A carrier that utilizes a provider panel shall establish written procedures for reviewing applications for participation in the provider panel.
- B. A carrier that utilizes a provider panel shall, upon request, make its applications publicly available.
C. The form of application:
- (1) Shall include instructions for completion of the application;
- (2) Shall provide a specifically designated space for dating the receipt of the application by the carrier; and
- (3) Shall comply with federal and State laws concerning the Americans with Disability Act.
D. A carrier shall maintain an application log which, at a minimum, provides the following information:
- (1) Name of the provider requesting or submitting the application;
- (2) Date the provider requested an application, if applicable;
- (3) Date the application is sent or delivered to the provider, if applicable;
- (4) Date the application is received from the provider;
- (5) Date the application is returned to the provider with a request for additional information to complete the application, if applicable;
- (6) Date of receipt by the carrier of an application previously returned for additional information, if applicable;
(7) Date that the provider is notified of:
- (a) Rejection, or
- (b) Carrier's intent to continue the credentialing process; and
- (8) Date after completion of credentialing that the provider is notified of acceptance or rejection in the provider panel.
- E. The log shall be available for inspection by the Commissioner.
F. Notice.
(1) A carrier shall:
(a) If the carrier maintains a web site:
- (i) Post on the web site a notice of how to apply to the carrier's provider panel; and
- (ii) Provide, on request, a paper copy of the notice of how to apply to the carrier's provider panel; or
- (b) If the carrier does not maintain a web site, provide on request a paper copy of the notice of how to apply to the carrier's provider panel.
- (2) The notice required pursuant to §F(1) of this regulation shall include relevant addresses and telephone numbers for contact purposes.
Authority: Insurance Article, §§2-109 and 15-112, Annotated Code of Maryland
Effective date: June 17, 1996 (23:12 Md. R. 870)
Chapter recodified from COMAR 09.31.13 to COMAR 31.10.16 effective September 7, 1998 (25:18 Md. R. 1439)
Regulation .03C amended effective April 21, 2008 (35:8 Md. R. 812)
Regulation .03D amended effective May 9, 2016 (43:9 Md. R. 532)
Regulation .03F amended effective December 23, 2002 (29:25 Md. R. 1984)
Regulation .05B amended effective December 6, 2018 (45:24 Md. R. 1164)