Iowa HF556 amends the health insurer credentialing process, requiring insurers to respond to credentialing requests within 56 days and allowing for.

Iowa HF556 modifies the health insurer credentialing process. It mandates that insurers respond to credentialing requests from physicians, advanced registered nurse practitioners, or physician assistants within 56 calendar days. If a request is denied, the insurer must provide a written reason and offer an internal appeal process. After an internal appeal, the provider can appeal the denial to the insurance division, with network adequacy as a valid ground for appeal. The bill also requires retrospective payment for clean claims during the credentialing period.

Iowa HF556 amends the health insurer credentialing process, requiring insurers to respond to credentialing requests within 56 days and allowing for.

Iowa HF556 modifies the health insurer credentialing process. It mandates that insurers respond to credentialing requests from physicians, advanced registered nurse practitioners, or physician assistants within 56 calendar days. If a request is denied, the insurer must provide a written reason and offer an internal appeal process. After an internal appeal, the provider can appeal the denial to the insurance division, with network adequacy as a valid ground for appeal. The bill also requires retrospective payment for clean claims during the credentialing period.