Bill mandates 60-day timeline for healthcare provider credentialing process

A new bill aimed at streamlining the credentialing process for healthcare providers took center stage during the Senate Labor, Health & Social Services Committee meeting on February 12, 2025. The proposed legislation, referred to as the "health carriers" bill, sets clear timelines for insurers to respond to credentialing applications, marking a significant shift in how healthcare providers interact with insurance companies.

Key provisions of the bill include a seven-day response time for insurers to acknowledge receipt of a credentialing application. Following this, insurers have a 30-day window to address any incomplete applications. Healthcare providers are then required to submit any necessary information back to the insurers within another 30 days. The ultimate goal is to ensure that the entire credentialing process—from application to final determination—takes no longer than 60 days.

The bill also includes provisions for rulemaking authority, which will allow for the establishment of guidelines regarding reimbursement for healthcare services once providers are credentialed and contracted within the insurance network. This aspect of the legislation aims to enhance the efficiency of healthcare delivery and ensure that providers are compensated promptly for their services.

The committee's discussions highlighted the importance of this bill in improving the operational dynamics between healthcare providers and insurers, potentially leading to better patient care outcomes. As the bill moves forward, stakeholders are optimistic about its impact on reducing delays in credentialing and enhancing access to healthcare services across Wyoming.