Provider Manual Page 1 2 3 4 5
Credentialing
The initial credentialing process includes:
- Physician application to be completed in its entirety
- Copies of ( and verification of)
- Licensure(s)
- DEA Registration
- Professional Liability Malpractice Insurance (face sheet from physician's liability policy)
- Degree
- Board Certification - if not board certified, verification internship, residency and fellowship training (if applicable)
- Hospital Privileges
(if not, whom do admit, if applicable)
- Copy of Curriculum Vitae/Resume (Complete work history)
As documents from any of these areas expire, it is "imperative" that we receive the updated information as quickly as possible.
Recredentialing
4MOST Health Network recredentials all providers in the network, Primary Care Physicians, Obstetricians/Gynecologist, and Specialists at least every three years. The recredentialing process includes verification of:
- Licensure(s)
- DEA Registration
- Professional Liability Malpractice Insurance (face sheet from physician's liability policy)
- Board Certification
- if not board certified, verification internship, residency and fellowship training (if applicable)
- Current, adequate malpractice insurance
- Professional liability claims history
- Application
- Hospital Privileges
(if not, whom do you admit, if applicable)
Standards for Participation
To become a 4MOST Health Network provider, 4MOST must then assess the need in the requested geographic location, if this assessment shows a need, provider will be sent a credentialing applications and participation agreement. Physician must be credentialed and meet the standards of participation as developed by 4MOST in association with participating physicians.
A physician must have the following credentials.
- Drug Enforcement Administration (DEA) registration number if the scope of practice would warrant the physician to have a DEA
- Professional Liability Malpractice Insurance - minimum amount of $1 million per occurrence, $3 million aggregate
- Admitting Privileges at a participating hospital
(if applicable)
- Query from the National Practitioner Data Bank
(NPDB)
- Query of The Office of Inspector General
- Board Certified or Board Eligible, if not Board Certified or Board Eligible, the physician must demonstrate appropriate training for specialty listed
- Proof of medical license
- Sufficient information concerning any malpractice actions pending or resolved and any board sanctions or consent aggrement/order
- Completed confidential questionnaire
- Signed and dated provider agreement and application
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