Credentialing review process
Your application is complete when Priority Health has received, verified and/or completed the following:
- Completed application and signed attestation and release, including curriculum vita, copies of professional liability insurance (minimum limits of $100,000/ $300,000)
- Professional liability claims history, verified directly with the National Practitioner Data Bank
- Michigan Physician and Controlled Substance licenses, verified online through the National Technical Institute Service of the U.S. Department of Commerce.
- Federal DEA license verified
- Graduation from medical school, verified directly with the medical school or by theAmerican Board of Medical Specialists (ABMS) or American Osteopathic Association(AOA) listings
- Residency and fellowship (if applicable) verified directly with the training program or by the ABMS or AOA listings
- Board Certification, verified with the ABMS, AOA, American Board of Podiatric Surgery, American Board of Podiatric Orthopedics and Primary Podiatric Medicine,American Board of Oral Surgery, or American Board of Sleep Medicine listings (unless the physician completed clinical training prior to 1989 and practices in a rural or underused area, or an area with insufficient provider coverage, or a specialty in which there is a shortage of providers)
- Current and previous hospital memberships, verified by mail, fax and/ or phone
- Medicare Opt-out Report
- National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB), queried online to verify any disciplinary actions, malpractice payments and Medicare/ Medicaid sanctions
- MDCH - Medical Services Administration Sanctioned Providers
- Office of Inspector General Sanctioned Provider Exclusion Database
- Three letters of recommendation from physicians who are familiar with the applicant's clinical skills and who are not employed with or partners of his or her prospective physician group
- Pre-credentialing site visit to all PCPs and OB/GYNs to ensure compliance with Michigan Department of Community Health and Priority Health standards
