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31.10.26.00.htm 31.10.26.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 10 HEALTH INSURANCE ― GENERAL Chapter 26 Uniform Credentialing Form Authority: Insurance Article, §2-109 and 15-112.1, Annotated Code of Maryland
31.10.26.01.htm 31.10.26.01. 01 Scope.. This chapter applies to all:. A. Carriers as defined in Regulation .02B(1) of this chapter; and. B. Credentialing intermediaries as defined in Regulation .02B(2) of this chapter..
31.10.26.02.htm 31.10.26.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) Carrier.. a) "Carrier" means:. i) An insurer;. ii) A nonprofit health service plan;. iii) A health maintenance organization;. iv) A dental plan organization; or. v) Any other person that provides health benefit plans subject to regulation by the State.. b) "Carrier" includes an entity that arranges a provider panel for a carrier.. 2) "Credentialing interme
31.10.26.03.htm 31.10.26.03. 03 Uniform Credentialing Form ― Carrier and Credentialing Intermediary Requirements.. A. A carrier or its credentialing intermediary shall:. 1) Accept the uniform credentialing form as the sole application for a health care provider to become credentialed or recredentialed for a provider panel of the carrier; and2) Make the uniform credentialing form available to any health care provider that is to be credentialed or recredentialed by the carrier or credentialing intermediary.
31.10.26.04.htm 31.10.26.04. 04 Electronic Filing.. A. The uniform credentialing form may be obtained in an electronic format.. B. The uniform credentialing form may be transmitted by facsimile.. C. A transmission by facsimile is not considered an electronic transfer for the purposes of this chapter.D. Capability of Electronic Filing.. 1) The uniform credentialing form developed under this chapter shall be capable of electronic filing.2) The uniform credentialing form may be filed electronically in any format
31.10.26.05.htm 31.10.26.05. 05 Effective Date.. The regulations in this chapter are applicable for all credentialing and recredentialing forms used on or after January 1, 2008.
31.10.26.9999.htm 31.10.26.9999. Administrative History Effective date: December 25, 2000 (27:25 Md. R. 2285). Chapter revised effective December 6, 2007 (34:24 Md. R. 2159). Regulation .03B amended effective January 20, 2014 (41:1 Md. R. 13). Regulation .03F adopted effective January 20, 2014 (41:1 Md. R. 13).
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