PROVIDER CREDENTIALING

Credentialing Applications

Credentialing Applications are required by HealthSmart in order to join a HealthSmart PPO network. If your state has a standard application form, HealthSmart will accept the form in lieu of completing a provider application. HealthSmart participates in the Universal Credentialing DataSource, a project of the Council for Affordable Quality Healthcare (CAQH). On all new or initial provider credentialing, HealthSmart will accept the print-out of your information from the CAQH website. (See the bottom of the page for recredentialing procedures.) For more information on Credentialing Applications, contact our Provider Credentialing Department at 866-511-4757.

State Credentialing Applications

STATE STATE MEDICAL BOARD CREDENTIAL APPLICATION
Alabama Alabama State Board of Medical Examiners
http://www.albme.org
From the Alabama Hospital Association
Alaska Alaska State Medical Board
http://www.commerce.state.ak.us/occ/pmed.htm
 
Arizona Arizona Medical Board
http://www.azmd.gov
 
Arkansas Arkansas State Medical Board
http://www.armedicalboard.org/index.asp
 
California Medical Board of California
http://www.medbd.ca.gov
 
Colorado Colorado State Board of Medical Examiners
http://www.dora.state.co.us/medical
 
Connecticut Connecticut Department of Public Health
http://www.dph.state.ct.us
 
Delaware Delaware Board of Medical Practice
http://dpr.delaware.gov
 
District of Columbia District of Columbia Board of Medicine
http://www.dchealth.dc.gov
Credentialing via CAQH Login or Register
Florida Florida Board of Medicine
http://www.doh.state.fl.us
Florida Uniform Credentialing
Georgia Georgia Board of Medical Examiners
http://medicalboard.georgia.gov
Credentialing via CAQH Login or Register
Hawaii Hawaii Board of Medical Examiners
http://www.hawaii.gov/dcca/areas/pvl/boards/medical
 
Idaho Idaho State Board of Medicine
http://www.bom.state.id.us
 
Illinois Illinois Department of Professional Regulation
http://www.dpr.state.il.us
Illinois Credentialing
Indiana Indiana Health Professions Bureau
http://www.in.gov/pla
Credentialing via CAQH Login or Register
Iowa Iowa Board of Medicine
http://medicalboard.iowa.gov
 
Kansas Kansas State Board of Healing Arts
http://www.ksbha.org
Credentialing via CAQH Login or Register
Kentucky Kentucky Board Medical Licensure
http://kbml.ky.gov
Credentialing via CAQH Login or Register
Louisiana Louisiana State Board of Medical Examiners
http://www.lsbme.la.gov
Credentialing via CAQH Login or Register
Maine Maine Board of Licensure in Medicine
http://www.docboard.org/me/me_home.htm
 
Maryland Maryland Board of Physician Quality Assurance
http://www.mbp.state.md.us
Credentialing via CAQH Login or Register
Massachusetts Massachusetts Board of Registration in Medicine
http://www.massmedboard.org
 
Michigan Michigan Board of Medicine Michigan Credentialing
Minnesota Minnesota Board of Medical Practice
http://www.bmp.state.mn.us
 
Mississippi Mississippi State Board of Medical Licensure
http://www.msbml.state.ms.us
 
Missouri Missouri Board of Registration, Healing Arts
http://www.pr.mo.gov/healingarts.asp
Credentialing via CAQH Login or Register
Montana Montana Board of Medical Examiners
http://www.medicalboard.mt.gov
 
Nebraska Nebraska Health and Human Services System
http://www.hhs.state.ne.us
 
Nevada State of Nevada Board of Medical Examiners
http://www.medboard.nv.gov
 
New Hampshire New Hampshire Board of Medicine
http://www.nh.gov/medicine
 
New Jersey New Jersey State Board of Medical Examiners
http://www.state.nj.us/lps/ca/medical.htm
Credentialing via CAQH Login or Register
New Mexico New Mexico Medical Board
http://www.nmmb.state.nm.us
 
New York New York State Board for Medicine
http://www.op.nysed.gov
 
North Carolina North Carolina Medical Board
http://www.ncmedboard.org
North Carolina Credentialing
North Dakota North Dakota Board of Medical Examiners
http://www.ndbomex.com
 
Ohio State Medical Board of Ohio
http://www5.state.oh.us/med
Credentialing via CAQH Login or Register
Oklahoma Oklahoma State Board of Medical Licensure
http://www.okmedicalboard.org
In PDF Format
In Word Format
Oregon Oregon Board of Medical Examiners
http://egov.oregon.gov/BME
 
Pennsylvania Pennsylvania State Board of Medicine
http://www.dos.state.pa.us/bpoa/site/default.asp
 
Rhode Island Rhode Island Board of Medical Licensure
http://www.health.ri.gov/hsr/bmld
Credentialing via CAQH Login or Register
South Carolina South Carolina Board of Medical Examiners
http://www.llr.state.sc.us/pol/medical
 
South Dakota South Dakota Board of Medical Examiners
http://www.medicine.sd.gov
 
Tennessee Tennessee Department of Health
http://health.state.tn.us
Credentialing via CAQH Login or Register
Texas Texas State Board of Medical Examiners
http://www.tmb.state.tx.us
In PDF Format
In Word Format
Utah State of Utah Department of Commerce
http://www.dopl.utah.gov
 
Vermont Vemont Board of Medical Practice
http://healthvermont.gov/hc/med_board/bmp.aspx
Credentialing via CAQH Login or Register
Virginia Virginia Board of Medicine
http://www.dhp.virginia.gov
 
Washington Washington State Department of Public Health
http://www.doh.wa.gov/PHIP/default.htm
 
West Virginia West Virginia Board of Medicine
http://www.wvdhhr.org/wvbom
 
Wisconsin State of Wisconsin Medical Examining Board
http://drl.wi.gov/index.htm
 
Wyoming Wyoming Board of Medicine
http://wyomedboard.state.wy.us