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
 

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