This bill mandates the Superintendent of Insurance to establish rules that create a standardized and efficient process for the credentialing of dentists and dental hygienists by health insurance carriers. It requires that health insurance carriers assess and verify the qualifications of applicants within thirty calendar days of receiving a complete credentialing application. If the carriers fail to load the approved applicants' information into their provider payment systems within this timeframe, they are obligated to reimburse the dentists or dental hygienists for covered services rendered after the application date. The bill also allows for an extension of the credentialing period by an additional fifteen days under certain circumstances.
Additionally, the bill stipulates that health insurance carriers must notify applicants within ten working days if any further information is needed to process their applications. It outlines the conditions under which reimbursement is required, including the necessity for the dentist or dental hygienist to have submitted a complete application and to have no licensing sanctions. The bill also includes provisions for resolving disputes related to reimbursement and credentialing delays, ensuring that dentists and dental hygienists are compensated fairly while their applications are being processed.