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In
order for NCC
to maintain its standards of
excellence, we have implemented
a credentialing process to
ensure providers offer a level
of care that is in agreement
with accepted standards of
medical care in the community.
To ensure continued compliance
with quality standards, NCC
providers are re-credentialed
every two years, at which time a
new application is to be filled
out and returned with updated
copies of medical licenses, DEA
certificate, and malpractice
insurance coverage. Through our
state-of-the-art Provider
Tracking System, key dates (such
as license expiration) trigger
electronic notification to our
Provider Relations Department.
In the event of a potential
expiration prior to the two-year
renewal process, providers are
contacted so NCC
may obtain updated information.
In order to qualify as a member
of the NCC
PPO, a health care professional
or organization must meet the
following criteria:
 | Complete
the NCC
PPO application. Willful
falsification of any
information on the
application will result in
non-acceptance or
termination. |
| Agree
to accept discount off the
state mandated fee
schedule or usual and
customary as payment in
full for covered services
delivered to NCC's
subscribers. |
| Be
licensed by the state
without restriction. |
| Maintain
professional liability
insurance limits as
required by NCC. |
| Affirm
that none of the following
has occurred:
 | felony
conviction. |
| suspension
or revocation of
professional or drug
license. |
| forced
restriction or
revocation of
hospital privileges. |
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| Agree
to adhere to NCC's
quality assurance and
utilization management
guidelines. |
| Demonstrate
practice patterns,
utilization patterns and
other practice
characteristics compatible
with the objectives of NCC
and
it's clients. |
| Comply
with state regulations
regarding radiology,
pharmacy services,
facility standards and
patient records. |
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| Phone:
800.213.1009 |
Fax:
210.828.1800 |
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Copyright © 1994-2004 National ChoiceCare, Inc.
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