Uniform Credentialing Application - The Alabama Uniform Provider Application may be used by physicians who wish to be credentialed. This form was developed through a cooperative effort of the Medical Association of the State of Alabama, the Alabama Association of Medical Staff Services, the Alabama Association of Health Plans, the Alabama Medicaid Agency, the Medical Group Management Association of Alabama, and the Alabama Hospital Association. Please note that the application may be submitted electronically to Blue Cross Blue Shield of Alabama at this time. A blank provider application may also be printed.
Below is a list of health plans/insurers which accept the form:
Blue Cross Blue Shield of Alabama
Alabama Medicaid Agency
Viva Health
HealthSpring of Alabama
Direct Care America (Ohio)
North Alabama Managed Care, Inc. (NAMCI)
MultiPlan
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hpo, ltd.
PHCS
USA MCO
Below is a list of hospitals which accept the form:
Baptist Health System, Birmingham
Baptist Cherokee, Centre
Baptist Citizens, Talladega
Baptist DeKalb, Fort Payne
Baptist Lawrence, Moulton
Baptist Montclair, Birmingham
Baptist Princeton, Birmingham
Baptist Shelby, Alabaster
Baptist Walker, Jasper
Chilton Medical Center, Clanton
Community Hospital, Tallassee
Coosa Valley Medical Center, Sylacauga
D.W. McMillan Memorial Hospital, Brewton
Huntsville Hospital, Huntsville
Jackson County Hospital, Scottsboro
Red Bay Hospital, Red Bay
Southeast Alabama Medical Center, Dothan
Wedowee Hospital, Wedowee