MP CR 6A Policy/Procedure Number: Lead Department: Provider Relations Policy/Procedure Title: Initial Credentialing Requirements for Policy ☒External (Allied Health) Practitioners Internal Policy ☐ Next Review Date: Original Date: 03/10/2004 Last Review Date: 02/14/2018 Applies to: Medi-Cal ☒ Employees IQI P & T QUAC Reviewing ☒ ☐ ☐ Entities: OPerations Executive Compliance Department ☐ ☐ ☐ ☐ BOARD COMPLIANCE FINANCE PAC ☐ ☐ ☐ ☐ Approving Entities: CEO COO Credentialing DEPT. DIRECTOR/OFFICER ☐ ☐ ☒ ☐ Approval Signature: Archive Date: 08/08/2018 Marshall Kubota, MD : : : : :
Policy/Procedure Number: MP CR 6A Lead Department: Provider Relations Policy/Procedure Title: Initial Credentialing Requirements for (Allied Health) Practitioners ☒External Policy ☐ Internal Policy Original Date: 03/10/2004 Next Review Date: Last Review Date: 02/14/2018 Applies to: ☒ Medi-Cal Employees Reviewing Entities: ☒ IQI ☐ P & T ☐ QUAC ☐ OPerations ☐ Executive ☐ Compliance ☐ Department Approving Entities: ☐ BOARD ☐ COMPLIANCE ☐ FINANCE ☐ PAC ☐ CEO ☐ COO ☒ Credentialing ☐ DEPT. DIRECTOR/OFFICER Approval Signature: Marshall Kubota, MD Archive Date: 08/08/2018 : : : : :
MPCR6A.docx