ਪ੍ਰਦਾਤਾ ਮੈਨੂਅਲ

ਮੁਹੱਈਆ ਪ੍ਰਬੰਧਨ

Though Carelon is able to resolve most provider credentialing and quality issues through consultation and education, occasionally further action is necessary to ensure quality service delivery and protection of members. The National Credentialing Committee (NCC) may impose provider sanctions for issues related to member complaints/grievances, quality of care or provider contract compliance. Carelon will comply with all applicable local, state and federal reporting requirements regarding professional competence and conduct to ensure the highest quality of care for our members. A provider has the right to appeal any sanction through the Carelon ਪ੍ਰਦਾਤਾ ਅਪੀਲ ਕਮੇਟੀ (ਪੀਏਸੀ) / ਨਿਰਪੱਖ ਸੁਣਵਾਈ ਅਪੀਲ ਦੀ ਪ੍ਰਕਿਰਿਆ. ਹੇਠਾਂ ਐਨਸੀਸੀ ਅਤੇ ਪੀਏਸੀ ਲਈ ਉਪਲਬਧ ਪਾਬੰਦੀਆਂ ਦੀ ਸੂਚੀ ਹੈ:

ਵਿਅਕਤੀਗਤ ਪ੍ਰੈਕਟੀਸ਼ਨਰ ਮਨਜੂਰੀ