Provider Credentialing & Screening

We implement procedures to screen, verify and credential clinical and administrative staff for participation in BHS programs funded by federal insurance programs (like Medicaid and Medicare) as well as other payers (like the County General Fund, Healthy Workers, etc.)

Request Credentialing for Organizational/Agency Providers

To request credentialing for a staff member who works within an Organization/Agency, you should:


1. Download the attached pdf file

2. Enter information on Page 1

3. Submit the form to (from there, Avatar accounts will forward to BHS Credentialing).

Request Credentialing for Private Provider Network

To request credentialing for an individual working in our Private Provider Network, you should:


1. Use this link to our webform--you will enter your name, NPI number and your email address

2. Monitor your email--you will receive an email from "" within 48-72 hours

3. When you receive the email, open the email--and then click the URL link for MD Staff

4. Use the web-based MD Staff software to enter information and to sign the required forms

Communicate Staff Separation from Organization or PPN

To communicate staff separation for your staff member, you should:


1. Download the attached pdf file

2. Enter information on Page 2

3. Submit this form to and carbon copy (cc) the email to

Last updated November 4, 2022