{"data":{"id":"us-ky/krs-304.17a-576","jurisdiction":"us-ky","citation":"KRS 304.17A-576","heading":"Notice by managed care plan insurer of health care provider's","body":"application for credentialing -- Payments to applicant.\n(1) An insurer issuing a managed care plan shall notify an applicant of its determination\nregarding a properly submitted a pplication for credentialing within forty -five (45)\ndays of receipt of an application containing all information required by the most\nrecent version of the Council for Affordable Quality Healthcare (CAQH)\ncredentialing form. Nothing in this section shall p revent an insurer from requiring\ninformation beyond that contained in the credentialing form to make a\ndetermination regarding the application.\n(2) The forty-five (45) day requirement set forth in subsection (1) of this section shall\nnot apply if the failure to notify is due to or results from, in whole or in part, acts or\nevents beyond the control of the insurer issuing a managed care plan, including but\nnot limited to acts of God, natural disasters, epidemics, strikes or other labor\ndisruptions, war, civi l disturbances, riots, or complete or partial disruptions of\nfacilities.\n(3) Following credentialing, the applicant and, upon the applicant's signing of a contract\nwith the managed care plan, the insurer shall make payments to the applicant for\nservices re ndered during the credentialing process in accordance with procedures\nfor reimbursement for participating providers.\n(4) An applicant for which an application for credentialing is denied shall be\nreimbursed, if the enrollee is enrolled in a plan which prov ides for out -of-network\nbenefits, by the insurer issuing a managed care plan in accordance with procedures\nfor reimbursement to nonparticipating providers.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=48418","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:47Z","sha256":"657151259091fb2ad67d54adcba0d601e243576a0092db31cb1cff2ffcdaba9e","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-575","next":"us-ky/krs-304.17a-577"},"notice":"GroundRules: Original legal text. Not legal advice."}