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Through the credentialing process, our highly trained staff reviews and evaluates the qualifications of physicians and other health care specialists. Before a physician is approved to participate in the network they must meet defined requirements for education, licensure, and professional standing. The practitioner must also offer services that are available to meet the needs of health plan members and have office hours available to handle both routine appointments and emergency situations. As part of our "recredentialing" process, our staff reviews this information at least every three years for all of our participating providers. We obtain routine updates regarding their licensure and professional standing. We also review their performance through quality monitoring including member complaints and adverse events. Medical facilities are also reviewed through this credentialing and recredentialing process. If you have any questions about your participating provider or medical facility, please feel free to contact Member Services.



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