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Mountain State Standardizes Provider Credentialing

By Staff Writer

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Vermont has endorsed efforts by the Council for Affordable Quality Healthcare to reduce red tape for doctors.

Starting this year, insurers and hospitals in Vermont must use a provider “credentialing” form developed by the CAQH, Alexandria, Va., when seeking information about doctors’ education and experience, officials at the Vermont Department of Banking, Insurance, Securities and Health Care Administration report in Bulletin HCA – 122.

Hospitals and insurers can use supplemental forms, and they can set their own rules for how doctors should complete the CAQH form, officials say.

The Vermont department is setting the CAQH form requirement in response to a law passed by Vermont lawmakers in 2006.

CAQH itself developed the form in response to complaints from doctors that each hospital and insurer was asking for similar credentialing information in a completely different way.

Although the requirement to use the CAQH form took effect Jan. 1, the Vermont department will not begin enforcing the requirement until July 1, officials say.

A copy of the credentialing bulletin is on the Web at Document Link