Health Center Medical Provider Credentialing

 

All medical providers working in CHCN health centers must be credentialed by Alameda Alliance for Health including volunteers, on-call, and specialty providers. Please notify CHCN immediately upon hire and submit all required credentialing materials to Alameda Alliance for Health for new hires within 30 days. Providers are required to submit credentialing materials for the following types of medical providers.

 

Physicians*:

·    Medical Doctor (MD)

·    Doctor of Osteopath (DO)

*Including volunteer, on-call, or specialty providers

 

 

Advanced Practice Professionals (APPs)*:

·    Nurse Practitioner (NP)

·    Physician Assistant (PA)

·    Certified Nurse Midwife (CNM)

*Contact Alameda Alliance for Health at DeptCredentialing@alamedaalliance.org about other provider types that are not list above.

 

 

Submit the following forms to CHCN’s Provider Services Department at providerservices@chcnetwork.org:

 

• Provider Add Form
• CHCN NPO Attestation Form

 

Please email the follow credentialing materials to Alameda Alliance for Health’s Credentialing Department at deptcredentialing@alamedaalliance.org:

 

• Provider Name
• Provider NPI
• CAQH #
• Supervising Physician Name + Attach Supervising Forms (if provider is a mid-level)
• Attach- HIV form (if provider would like to be listed as an HIV provider)
• Attach- Medi-Cal Proof of Submission (if provider is not yet enrolled)

 

**AAH does not require credentialing for locum providers, but please continue to send the provider add forms to CHCN.