KRS 304.17A-576: Notice by managed care plan insurer of health care provider's

application for credentialing -- Payments to applicant.

(1) An insurer issuing a managed care plan shall notify an applicant of its determination

regarding a properly submitted a pplication for credentialing within forty -five (45)

days of receipt of an application containing all information required by the most

recent version of the Council for Affordable Quality Healthcare (CAQH)

credentialing form. Nothing in this section shall p revent an insurer from requiring

information beyond that contained in the credentialing form to make a

determination regarding the application.

(2) The forty-five (45) day requirement set forth in subsection (1) of this section shall

not apply if the failure to notify is due to or results from, in whole or in part, acts or

events beyond the control of the insurer issuing a managed care plan, including but

not limited to acts of God, natural disasters, epidemics, strikes or other labor

disruptions, war, civi l disturbances, riots, or complete or partial disruptions of

facilities.

(3) Following credentialing, the applicant and, upon the applicant's signing of a contract

with the managed care plan, the insurer shall make payments to the applicant for

services re ndered during the credentialing process in accordance with procedures

for reimbursement for participating providers.

(4) An applicant for which an application for credentialing is denied shall be

reimbursed, if the enrollee is enrolled in a plan which prov ides for out -of-network

benefits, by the insurer issuing a managed care plan in accordance with procedures

for reimbursement to nonparticipating providers.