56-7-1009 - Health care provider credentialing applications from the Council on Affordable Quality Healthcare (CAQH).
56-7-1009. Health care provider credentialing applications from the Council on Affordable Quality Healthcare (CAQH).
(a) A health insurance entity, as defined in § 56-7-109, that credentials or recredentials the providers in its networks shall accept, in addition to its own credentialing and recredentialing applications, the credentialing and recredentialing applications from the Council on Affordable Quality Healthcare (CAQH). If the health insurance entity is a participating organization of CAQH, then the health insurance entity shall accept the application from either CAQH by electronic means or from the provider by electronic means or by a paper copy. If the health insurance entity is not a participating organization of CAQH, then the health insurance entity shall accept the application only from the provider by electronic means or by a paper copy. In either case, the provider shall complete and submit the attestation clause of the health insurance entity before an application is considered complete, if the health insurance entity requires it.
(b) Nothing in this section may be construed to require a health insurance entity to be a participating organization or pay a fee to CAQH.
[2005, ch. 167, § 1.]