Uniform Application for Credentialing

The Foundation for Healthy Communities worked with representatives from the New Hampshire Association Medical Staff Services and three of the major health plans in the state to develop a Uniform Application for Credentialing (Electronic / Hard Copy) to be used by physicians and other credentialed practitioners. The process has been highly collaborative and productive. Although the use of this form is voluntary, we encourage its use to maintain consistency between hospitals and health plans and decrease the administrative burden for physicians and other credentialed providers. The form will be reviewed and updated annually to ensure its compliance with regulatory and accrediting bodies.

The Uniform Application for Credentialing was approved by the JCAHO on July 8, 2004 and by NCQA on August 4, 2004.

For more information on the Uniform Application for Credentialing Form, contact Rachel Rowe at rrowe@healthynh.com.