Initial Appointment
Initial Appointment
In order to become a member of our medical staff, you must submit a completed application. The document listed below is considered, in its entirety, your application. Please note that your application will not be considered or processed until all of these documents are completed and received:
We utilize the Council for Affordable Quality Healthcare (CAQH) application as part of the credentialing process, which, according to H.B. 125, The Healthcare Simplification Act, is the only acceptable application for physician credentialing and reappointment in Ohio. You can find information on the CAQH application process at: www.caqh.org. If you have not completed a CAQH application online and need to be assigned a CAQH ID number, contact the Credentialing Verification Office at cvo@mchs.com.
Additional documents required for the credentialing process are included in the link below. You must print, complete, sign, and date all forms.
We must receive your application fee along with your medical staff application before it can be processed. Please note the application fee is a one-time fee and is non-refundable once the process has started. Fees are as follows:
- One Medical Staff: $500.00
- Two Medical Staffs: $800.00
- Three Medical Staffs: $1,000
Please make checks payable to: Mount Carmel Health System
Mount Carmel Health System is comprised of three (3) separate medical staffs:
- Mount Carmel Health (Mount Carmel East and Mount Carmel Grove City combined medical staff)
- Mount Carmel St. Ann's
- Mount Carmel New Albany