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.state.nh.us/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

Recredentialing with CAQH

HealthSmart will utilize CAQH for recredentialing. For those HealthSmart providers that have been credentialed and contracted with a HealthSmart network, we encourage you to use CAQH for the HealthSmart recredentialing process. This web-based solution allows you to store and manage your credentialing information online and share it with insurance carriers electronically. By using this single source, you'll no longer need to complete different credentialing applications for different insurance carriers. Just enter your information once and authorize insurance carriers (including HealthSmart) to access it.

How it works:

Logon to CAQH: https://upd.caqh.org/OAS/
Enter your CAQH Provider ID (if you don't know it, call CAQH at 1-888-599-1771)
Enter or update your information
Authorize HealthSmart to access your information electronically

For more information or to view an online demonstration of this tool, visit www.caqh.org.

Ancillary Credentialing

CREDENTIALING APPLICATION: ANCILLARY