You will receive a link to the email address provided from AppCentral to register and initiate the credentialing process. The application includes step-by-step instructions and a list of required supplemental documents to submit along with the application. Upon submission of the application and supplemental documents, a credentialing specialist is assigned and will provide you with personalized service to assist with completion of your application.
Please allow at least 8 weeks prior to your start date for this process to occur. It is ultimately your responsibility to seek licensure, credentialing and privileges in an expeditious manner, since your start date will not be final without them. Please check your email regularly to ensure you do not miss any forms or notifications. Please note emails may be inadvertently sent to your spam folder.
Required supplemental documents
- 2” x 2” Passport Size Color Photograph
- Current Curriculum Vitae
All dates must include month/year and from/to. - Certification, including BLS, ACLS, PALS, ATLA
- CME/CEU Certificate for the previous two (2) years
- Board Certification/Recertification including new and renewed.
If you are not board certified, an exemption letter will be requested from the Chair of the Department. - Current Florida Medical License (FML) with Florida address, include all active and inactive out of state medical licenses
- Current Drug Enforcement Administration (DEA) Certificate with Florida Address
- Copy of Current Florida Driver’s License
- Copy of Social Security Card
- Education and Training – Copies of medical degree, internships, residencies, fellowships, ECFMG
- Certificate(s)/Declaration of Liability Insurance – Ten (10) year history
- Peer References three (3) - Sources for professional peer recommendations are as follows: If you are recently out of training (within the year), one reference must be completed by your current program director. Otherwise, references must be from the training department chair or clinical service chair. All references must be of the same professional disciplines as yourself. Please provide full name, degree, phone number and email address.
- Delineation of Clinical Privileging Form/Job Description/Protocol (as applicable).
Applicants are required to submit practice data/case logs for the previous 24 months to document current clinical competence for the privileges requested. This information can usually be obtained through your EMR or by contacting your Medical Records or Billing departments. You must meet the minimum criteria requirements at the time of your application, as specified in the privileging criteria for your specialty.
UM Self-Insurance
Please complete the self-insurance plan application that will be sent to you upon the start of the credentialing process.
Provider Enrollment
Your Department administrator will send you a Florida Medicaid/Medicare enrollment packet via e-mail. Upon receiving the packet, you must follow the detailed instructions to complete the enrollment forms and provide the requested items. No earlier than two months prior to your start date, you must return the scanned copies of your Florida Medicaid/Medicare enrollment packet via e-mail to Provider Enrollment; this will initiate the Florida Medicaid/Medicare enrollment process.
Fingerprint Screening
All new hires must either have an eligible level II background screening for Florida Medicaid or complete a new screening. You may complete your level II background screening on campus with us; this can be scheduled as a part of an onsite visit prior to employment. If you are unable to complete this on campus, please contact the Credentialing team at 305-243-5711 for additional options.