Transcription of Provider Credentialing Application Instructions
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Provider Credentialing Application Instructions
Provider Credentialing Application Instructions Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. Mid-Atlantic Permanente Medical Group, This Credentialing /RECREDENTIALING Application is for Kaiser Permanente network Provider organizations and facilities. Important disclaimer: Submission of an Application does not constitute any obligation on the part of Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., the Mid-Atlantic Permanente Medical Group, or any other or related Kaiser Permanente entity to enter into a new contractual obligation nor renew an earlier contract. Please complete this Application in its entirety. We ask that you complete the Application electronically. Do not complete it by hand. We welcome any attachments, beyond those requested, that you may choose to include to support your Application .
Provider Credentialing Application Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. Mid-Atlantic Permanente Medical Group, P.C. Organization/Facility Information Organization Type ☐ Applied Behavioral Analysis (ABA) Therapy ☐ Acute Care Hospital ☐ Ambulance ☐ Ambulatory Surgery Center ☐ Behavioral Health Care Facility
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