WISCONSIN CREDENTIALING PETITION

     We, the undersigned, hereby request of the Wisconsin Office of the Insurance Commissioner to mandate the use of a single medical/dental/behavioral health insurance credentialing application. 

In an effort to allow providers to treat patients in a timely manner when entering a practice, to save money and time on the credentialing process at the provider and facility end, and to streamline the  carrier processing turnaround time, the use of one all-inclusive form or the use of a third-party data keeper (i.e. CAQH) that the medical health insurance carriers must accept and use to initiate and conclude the network status of any given medical/dental/behavioral health provider is our goal.

     We also would like this mandate to include: 1) an in-network effective date of the receipt date of the application or data pulled from a data keeper; 2) a less than 45 day turnaround time on processing of the application by the carriers; 3) and exclusions would be made for Medicare and Medicaid of Wisconsin (EDS).

     Currently, there are states using this format of credentialing.  They include but may not be limited to; Nevada, Colorado, Mississippi, Texas, Oregon, West Virginia, Oklahoma, New Jersey, North Carolina, Missouri, Illinois, Vermont, Minnesota, Massachusetts, Georgia, and Louisiana.

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