THP follows the standards established by the National Committee for Quality Assurance (NCQA) to credential and recredential practitioners and health delivery organizations. These standards include guidelines for performing primary source verification, conducting site visits, establishing a process for appeal rights and notification to authorities, and delegating credentialing.
For more information about NCQA, its standards or guidelines go to http://web.ncqa.org.
Download the Maryland Uniform Credentialing Form.
Primary source verification will be conducted on all applications to ensure that practitioners have the legal authority, appropriate training and experience to provide care to THP beneficiaries.
Mail the completed documents to:
THP TriState Health Partners
Attention: PHO/Managed Care Specialist
10715 Downsville Pike, Suite 103
Hagerstown, MD 21740
Dues and Assessments – Practitioners
Initial dues and assessments, if any, are payable to THP within thirty days of a statement from THP assessing such dues and/or assessments, as established by the Board of Directors from time to time. Currently, the initial dues are $2,500 and no additional assessments have been assessed since incorporation in 1995.
THP Site Survey
THP has a Credentialing Site Survey policy to assure that physician offices meet or exceed the standards of office practices in the community. The survey checklist reviews issues related to patient safety, confidentiality, and office operations. THP will provide guidance and education for offices that are not meeting the minimum standards and provide the necessary time for improvement goals to be implemented.
Although NCQA no longer requires an office site survey at the time of recredentialing, THP will continue to provide this valuable service to ensure that our physicians can take action, if necessary, to align with office practice standards and be confident that nothing has been overlooked.
The site survey checklist is available upon request. (goes to Contact Us)
THP Credentialing Committee
In keeping with NCQA guidelines, the THP Credentialing Committee uses a peer-review process to make recommendations to the Board of Directors regarding credentialing decisions. This provides the committee with the opportunity to obtain meaningful advice and expertise from participating physicians when it makes credentialing decisions.
If you have a question about or need any assistance with Credentialing, please contact Amanda Shaw at 240-313-9949 or contact her by e-mail.
