Participating providers in a health plan's network must undergo recredentialing on a regular basis. During recredentialing, a health plan typically reviews
A) a provider's current, updated application information, as well as provider's peer reviews and performance reports on the provider
B) a provider's current, updated application information, as well as the provider's education and prior work history
C) a provider's education and prior work history only
D) peer reviews and performance reports on a provider and the provider's prior work history only

Question

Quizplus · Accepted Answer

During recredentialing, a health plan typically reviews a provider's current, updated application information, as well as provider's peer reviews and performance reports on the provider. This helps the health plan ensure that the provider continues to meet the necessary standards for participation in the network. Option B, C, and D do not provide a complete picture of the recredentialing process.

Participating Providers in a Health Plan's Network Must Undergo Recredentialing