Okla. Admin. Code § 310:2-15-2

Current through Vol. 41, No. 19, June 17, 2024

Section 310:2-15-2 - Uniform application for credentialing of providers

(a) The application described in OAC 310:002-15-2(b) is intended for use pursuant to Title 63 O.S. Supp. 1998, Section 1-106.2.

(b) The uniform application for credentialing of providers requests the following:

(1) personal information;

(2) education, including medical, dental and professional schools;

(3) training, including internships, residencies, fellowships and preceptorships;

(4) professional licenses;

(5) certifications and registrations;

(6) academic appointments;

(7) health care affiliations;

(8) other professional work history;

(9) current professional practice;

(10) office billing information;

(11) attestation;

(12) copies of required documents; and

(13) any additional information needed to answer all questions fully.

Okla. Admin. Code § 310:2-15-2

Added at 16 Ok Reg 901, eff 1-5-99 (emergency); Added at 16 Ok Reg 1389, eff 5-27-99; Amended at 17 Ok Reg 687, eff 12-16-99 (emergency); Amended at 17 Ok Reg 2034, eff 6-12-00