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Insurance Credentialing for NP's in MD

Posted almost 11 years ago by Lorraine Diana

As you all know, laws in Maryland were changed in 2010 eliminating the written collaborative agreement for NP's.  Since that time, we are required to have a written attestation on file with the Board of Nursing that we consult, collaborate and refer to other health care providers and name a physician with whom we can consult.  

It has come to our attention in the past several weeks that both CareFirst and Priority Partners are now requiring NP's for credentialing or recredentialing to provide the insurers with a written attestation that they have a written collaborative agreement with a physician in the same specialty and who participates in their insurance plan. 

If you or your office manager have received notification of this requirement, please let us know and send a scanned copy of it to us.  Statute does not require us to have an attestation with a physician in our specialty; hence, the insurers should not either.  And the written collaborative agreement no longer exists in COMAR or the Nurse Practice Act.

We need to hear from you!  We are planning legal action and there is strength in numbers.  Please check with your office manager, billing company or credentialing office to see if this is being required of you by these two insurers.  


Comments

Elaine Crain over 10 years ago

Have had to send this form for my last 3 new NP hires - I rewrote the form and they have accepted it. I will send a copy to the gmail account. Elaine Crain, owner of Who Cares? We Do! walk in urgent care, Severna Park.

Christine Rawlings over 10 years ago

I am having problems with a few insurance companies requiring I have a supervising physician listed within the pt's chart and my prescriptions will not E prescribe unless my Rx's have the name of my "supervising physician" on each Rx.

Lorraine Diana over 10 years ago

Thank you both. This info helps as we move forward.


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