Provider Rights
CredeMtia must ensure that each Practitioner/Provider receives the following rights in a
continuous basis during the Credentialing and Re-Credentialing process, as established by state
and federal requirements:
• The Practitioner/Provider has the right to review information submitted to support their credentialing application, attestation, or Curriculum Vitae.
• The Practitioner/Provider has the right to correct erroneous information submitted.
• The Practitioner/Provider has the right to be informed of the status of their
Credentialing or Re- credentialing application upon request.
• The Practitioner/Provider has the right to be notified of the process in writing
during initial credentialing, upon request.
• The Practitioner/Provider has the right to be treated without discrimination of sex,
color, race, age, disability, religion, and sexual orientation.
• The Practitioner/Provider has the right to receive the services related to the
Credentialing and Re-Credentialing processes in a nondiscriminatory manner.
• The Practitioner/Provider has the right to clarify significant discrepancies identified
by CredeMtia between information submitted and provided by the
Practitioner/Provider versus the information collected by CredeMtia.
• The Practitioner/Provider submitting an application for a Private Health Insurance
the Insurance Commissioner if in disagreement with the notification that the
Uniform Application Form is incomplete or incorrect. The process for this appeal
will be set for by the Office of the Insurance Commissioner.