This guide will serve as your map to learning the language, definitions, rules, requirements and methods to master the art of credentialing.


Credentialing Quick Start Guide


Appendix A:  Credentialing Tracking Tool

Appendix B:  Credentialing Check List

Appendix C:  Pre-Credentialing Form

Appendix D:  Telephone Verification Form

Appendix E:  Privileging Form – Physician

Appendix F:  Privileging Form – Dentist

Appendix G:  Privileging Form – Behavioral Health and Social Services

Appendix H:  Policy and Procedures – Overview of Policies and Procedures

Appendix I:  Policy and Procedures – Provider Application Process

Appendix J:  Policy and Procedures – Initial Credentialing Primary Source Verification

Appendix K:  Policy and Procedures – Re-Credentialing Primary Source Verification

Appendix L:  Policy and Procedures – Licensure of Practitioners

Appendix M:  Policy and Procedures – DEA and/or CDS Certification

Appendix N:  Policy and Procedures – Education and Training

Appendix O:  Policy and Procedures – Board Certification

Appendix P:  Policy and Procedures – Work History

Appendix Q:  Policy and Procedures – Malpractice Coverage

Appendix R:  Policy and Procedures – Malpractice History

Appendix S:  Policy and Procedures – Medicare/Medicaid Sanctions

Appendix T:  Policy and Procedures – Hospital Privileges

Appendix U:  Policy and Procedures – Professional References

Appendix V:  Policy and Procedures – Confidentiality and Data Integrity

Appendix W:  Policy and Procedures – Credentials Files

Appendix X:  Policy and Procedures – Criminal Background Checks