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Organizational Provider Initial Credentialing Application Demographic / General information D.B.A. (as signage indicates): Corporate name (as assigned TIN on W9): Facility Tax Identification Number:
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What is organizational provider initial credentialing?
Organizational provider initial credentialing is the process of evaluating and verifying the qualifications of a healthcare organization before allowing them to participate in a network or provide services.
Who is required to file organizational provider initial credentialing?
Healthcare organizations and providers are required to file organizational provider initial credentialing.
How to fill out organizational provider initial credentialing?
Organizational provider initial credentialing is typically filled out online through a portal provided by the insurance company or healthcare network.
What is the purpose of organizational provider initial credentialing?
The purpose of organizational provider initial credentialing is to ensure that healthcare organizations meet certain standards and qualifications before being allowed to provide services to patients.
What information must be reported on organizational provider initial credentialing?
Information such as licenses, certifications, education, work history, malpractice history, and references must be reported on organizational provider initial credentialing.
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