Credentialing

The Network contracts with a Management Services Organization (MSO) for credentialing s services. The MSO performs primary sources verification and submits its findings at the monthly Physicians Council meeting, where the physicians review the provider's credentials for possible inclusion in the Network. 

Health centers in the Network have both contracts in which they have been delegated for credentialing by the payor and contracts where the credentialing responsibility is still maintained by the health plan.  In cases where the health plan still performs the credentialing function, the MSO forwards applications as they are completed to the health plan rather than waiting for the Physicians Council meeting.

The MSO also complies with the Bureau of Primary Health Care (BPHC) Provider Information Notice (PIN) 2002-22, Appendix A that outlines the JCAHO credentialing standards that have been adopted by BPHC for Federally Qualified Health Centers (FQHCs).