Get Sc Managed Care Uniform Re Credentialing Application Pdf

Completing the SC Managed Care Uniform Re Credentialing Application PDF online is a straightforward process that helps practitioners maintain their credentialing status. This guide provides clear, step-by-step instructions to help you navigate through each section of the form effectively.

Follow the steps to complete your application with ease.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred PDF editor.
2. Begin by filling out the personal information section. Provide your full name (last, first, middle initial), suffix, degree, and any maiden or other names if applicable. Also, include your place and date of birth.
3. Move on to the medical license/registration section. Indicate if you offer specific services like OB care and input your professional license numbers, issue dates, and expiration dates for all relevant states.
4. Next, fill out the education/training/hospital privileges section. Input details about your medical school, internship, residency, and fellowship, including dates and specialties. Document any CME credits completed in the last two years.
5. Proceed to the medical specialties section. Mention your primary and secondary specialties, board certifications, and any plans to take certifying exams if applicable.
6. Answer the questions section carefully. Provide truthful responses regarding any pending legal issues or past disciplinary actions.
7. In the authorization section, certify that all provided information is accurate. Ensure to sign and date the application by writing your name in ink; electronic signatures are not acceptable.
8. Lastly, review all filled information for accuracy. You can then save the changes, download the completed application, and print it for submission.

Start your online credentialing process now by filling out the SC Managed Care Uniform Re Credentialing Application PDF.