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.
☐ Home Health Agency ☐ Hospice ☐ Hospital ☐ Lab ☐ Physical Therapy Provider ☐ Portable X-Ray Supplier ☐ Skilled Nursing Facility/Nursing Home ☐ Speech Pathology Provider ☐ Urgent Care Facility Provider Specialty (Including Subspecialties) 1. …
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