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Providers

Practitioner Credentialing Rights

Your Rights:

  • The right to review your credentialing/recredentialing information with the exception of references, recommendations, and peer protected information obtained by Keystone Mercy. If the Credentialing Department identifies a discrepancy on a provider’s credentialing/ recredentialing application, they will contact you, either telephonically or by mail, to correct and/or supplement the information submitted on your credentialing/recredentialing application.
  • The right to appeal any credentialing/recredentialing denial within 30 days of receiving written notification of the decision.
  • All documentation and other information received for the purpose of credentialing and recredentialing is considered confidential and is stored in a secure location that is only accessed by authorized plan associates
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