COMMUNITY HEALTH PLAN
Identifies the provider to whom the member(s) affected by the change will be transferred. The provider identified must meet the following criteria:
Provider must be in CHP s current Provider Network; b) Provider s specialty must be appropriate for member s age and sex; c) Provider must provide services at a location within a 10-mile radius of member s residence; and d) Provider must accommodate the member s primary language.
CHP DHS FACILITY LIAISON/ CONTRACT LIAISON
Reviews the for completeness and accuracy. Verifies any changes in telephone numbers by calling the listed numbers to validate that it is correct. Forwards to Credentialing and Site Certification.
Approves or denies the and forwards it to Provider Relations.
If approved, enters the change of information into the Change of Information file to be included in the monthly upload file containing adds, deletes, and changes to the provider
CREDENTIALING AND SITE CERTIFICATION