Uniform Credentialing Application

§63-1-106.2. Uniform application to be used in credentialing process.

     A. By January 1, 1999, the State Board of Health shall promulgate rules necessary to develop a uniform application which shall be used in the credentialing process of health care providers. The State Department of Health shall develop such application form for: 

    1. Initial privileges or membership in a hospital, managed care organization, or other entity requiring credentials verification; and

    2. Recredentialing or reappointment in a hospital, managed care organization, or other entity requiring credentials verification.

    B. Any entity requiring credentials verification may require supplemental information.
Added by Laws 1998, c. 210, § 1, eff. July 1, 1998. 

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Law and Rule

    Law Excerpt, 63-1-106.2 (12K)

    Rule Excerpt, 310:2-15 (10K) 

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Application

    Uniform Credentialing Application, ODH Form 606 (53K)

    Click here for the application in Word format. 

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Contact Information
John W. Judge, Jr.
Managed Care Systems
Health Resources Development Service
1000 N.E. 10th Street, Room 1011
Oklahoma City, OK 73117
Main  405.271.6868
Direct  405.271.9444, extension 57273
Fax  405.271.7360
E-mail   JohnWJ@health.ok.gov