P.R. Laws tit. 26, § 9323
For purposes of this chapter:
(a) Credentialing verification.— Is the process of obtaining and verifying information about a healthcare professional or entity, and evaluating that healthcare professional or entity, when such healthcare professional or entity applies to become a participating provider in a managed care plan offered by a health insurance organization or issuer.
(b) Primary verification.— Means verification by the health insurance organization or issuer of a healthcare professional or entity's credentials based upon evidence obtained directly from the issuing source of the credential.
(c) Secondary verification.— Means verification by the health insurance organization or issuer of a healthcare professional's credentials based upon evidence obtained by means other than direct contact with the issuing source of the credential (e.g., copies of certificates provided by the applying healthcare professional).
History —Aug. 29, 2011, No. 194, added as § 18.030 on Aug. 23, 2012, No. 203, § 3, eff. 90 days after Aug. 23, 2012.