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Provider Credentialing and Licensure Steps

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Congratulations on becoming a Renown Health provider! We are excited to have you on board!

This portal is designed to help you navigate through the onboarding process in chronological order and provide you with detailed completion instructions for important applications, forms, as well as anticipated deadlines for completion. The Provider Onboarding Guide, sent to you by your Provider Recruiter, includes essential deadlines for NV licensure, credentialing, and privileging, to ensure your start date remains on track. This guide also includes specialty-specific details for your practice location, department leaders, and if applicable, collaborating physician. If you need any assistance along the way, do not hesitate to reach out to your point of contact associated with each onboarding step. Before you begin reviewing the below onboarding steps, please take the time to watch the Provider Onboarding Video (coming soon). This video will provide you with a detailed guide of your next steps for Nevada licensure, the credentialing application, and HR requirements.  

New Provider Onboarding Requirements

Step 1: Nevada Licensure Applications

Point of Contact for Step 1: It is highly recommended that you work closely with the licensure specialists at the various State Boards through your licensure application and review processes. In addition, please ensure you keep both Medical Staff Services and your Practice Site Leader and/or Area Practice Manager updated as you progress through this step.

PART 1: Nevada Licensure Application - Submit Initial Application within 14 days of receiving your Provider Onboarding Guide.

Notify both Medical Staff Services and your Practice Site Leader and/or Area Practice Manager once your NV state license is active.

PART 2: Controlled Substance (CS) Application- Please go to Nevada Board of Pharmacy and select appropriate application, complete, and mail with within 14 days of receiving your Provider Onboarding Guide; this license does not apply to Psychologists or Therapists.

  • Physician
    • Register and complete PMP as instructed on Application
    • Print and mail the completed “Controlled Substance Application” and payment for the $200 Registration Fee to the NV State Board of Pharmacy. If your NV state license is pending, leave "Practitioner License Number" blank.
    • Once your NV state license has been issued, notify the NV State Board of Pharmacy of your NV state license number in order for your CS Application to be processed.
  • Nurse Practitioners
    • Experienced APRN: If you have practiced as an advanced practice registered nurse for at least 2 years (or have a minimum of 2,000 hours of clinical experience as an advanced practice registered nurse), your CS Application does not require a Collaborating Physician's signature.
      • Print and mail the completed “Advance Practitioner of Nursing – Prescribe”  and payment for the $200 Registration Fee to the NV State Board of Pharmacy. If your Permanent NV state APRN license is pending, leave "APRN license #" blank.
      • Once your NV state license has issued, notify the NV State Board of Pharmacy of your NV state license number in order for your CS Application to be processed.
    • APRN Requiring Collaborating Physician: If you have not practiced as an advanced practice registered nurse for at least 2 years (nor have a minimum of 2,000 hours of clinical experience as an advanced practice registered nurse), your CS Application will require a Collaborating Physician’s signature.
      • Print and mail the completed “Advance Practitioner of Nursing – Prescribe”  application and payment for the $200 Registration Fee to Renown Provider Enrollment (address below) for assistance with obtaining your Collaborating Physician’s signature. If your Nevada state license is pending, leave "APRN license #” blank on your CS Application. Once the Collaborating Physician’s signature has been obtained, Renown Provider Enrollment will submit the final application and payment to the NV State Board of Pharmacy for processing. 
      • Once your NV state license has issued, notify the NV State Board of Pharmacy of your NV state license number in order for your CS Application to be processed.
  • Physician Assistant
    • All PA Prescribe applications require the original signature of the Supervising Physician.
    • Print and mail the completed “Physician Assistant – prescribe” Application and payment for the $200 Registration Fee to Renown Provider Enrollment (address below) for assistance with obtaining your Supervising Physician’s signature. If your Nevada state license is pending, leave "Medical/Osteopathic Board PA #” blank on the CS Application. Once the Supervising Physician’s signature has been obtained, Renown Provider Enrollment will submit the final application and payment to the NV State Board of Pharmacy for processing. 
    • Once your NV state license has issued, notify the NV State Board of Pharmacy of your NV state license number in order for your CS Application to be processed.

Important Addresses and Contact Information

Nevada State Board of Pharmacy:

985 Damonte Ranch Parkway, Suite 206

Reno, NV 89521

P:775-850-1440

pharmacy@pharmacy.nv.gov

Renown Provider Enrollment:

1155 Mill Street, Mailstop M-14

Reno, NV 89502

MSOCred@renown.org

 

PART 3: DEA Licensure - Providers are not able to transfer an existing DEA to NV or apply for a new DEA for NV until they receive NV State Board of Pharmacy; this license does not apply to Psychologists or Therapists.

  • Providers without a DEA License: It is critical that you follow-up with the NV State Board of Pharmacy to ensure they have your NV state license number to process your CS Application. Once you receive your NV Pharmacy Licensure # from the NV State Board of Pharmacy with DEA instructions, proceed with submitting an application for a New DEA. 
  • Providers with an Existing DEA License: The decision to transfer an existing DEA license registered in another state or apply for a new DEA license in NV will depend on the timing of the issuance of your NV state license in your onboarding process. It is critical that you follow-up with the NV State Board of Pharmacy to ensure they have your NV state license number and can begin to process your CS Application.
    • In order to transfer an existing DEA license to NV, you will need to wait until the Board of Pharmacy emails you your NV Pharmacy License #. If at the time you receive the  NV Pharmacy License #, you still need to maintain your current DEA in another state for work purposes, you will need to proceed with applying for a new DEA in NV. However, if you no longer need your existing DEA registered in another state, you may proceed with transferring your existing DEA to NV. NOTE: Renown Credentialing does require a NV addressed DEA no later than 40 days prior to your start date to ensure timely submission of payor enrollment applications.

Helpful Links and Tips

PART 4: Additional Advance Practice Provider (APP) Forms

Collaboration Agreement Forms: The Collaboration Agreement Forms only apply to the following Advance Practice Providers (APPs). Note: this form requires original, notarized signatures for processing. The completed form may not be returned via fax or email.

Nurse Practitioners: If you have practiced as an advanced practice registered nurse for at least 2 years (or have a minimum of 2,000 hours of clinical experience as an advanced practice registered nurse), you do not need to complete a Collaboration Agreement.

Physician Assistants: All Physician Assistants, regardless of years of experience, are required to complete a Collaboration Agreement Form.

The original Collaboration Agreement form must be mailed to Renown Provider Enrollment. Renown Provider Enrollment will work with your department leaders to obtain your Collaboration Physician's signature, and submit the complete form to the appropriate NV State Board.

Renown Health Provider Enrollment

1155 Mill Street, Mailstop M-14

Reno, NV 89502

 

Statement of Supervising Physician for AHP Provider Form: If you are an Advance Practice Provider (APP) that will be working in a position requiring hospital privileges, please complete your portion of this form and mail to Renown Provider Enrollment, along with your Collaboration Agreement Form. If you are an APP that will be working in an outpatient clinic and does not need hospital privileges, you do not need to complete this form.

Download the Statement of Supervising Physician for AHP Provider Form

APRN Protocol for Prescription of Schedule II Controlled Substance Drugs

If you have not practiced as an advanced practice registered nurse for at least 2 years (not have a minimum of 2,000 hours of clinical experience as an advanced practice registered nurse), you will be required to submit a completed Protocol to the NV State Board of Nursing.

Download the APRN Protocol Letter

Important Items to Note:

  • This letter can be submitted via email with electronic signatures.
  • Once you have completed your portion of the Protocol and signed, you may email a copy to Renown Provider Enrollment (MSOCred@renown.org) to assist with obtaining your Collaborating Physician's signature.
  • The "will begin collaboration on" date needs to match the date your Collaboration Physician signed your Collaboration Agreement form. Provider Enrollment will be able to confirm this date.
  • Do not submit the completed form to the NV State Board of Nursing until you have a permanent APRN license. The completed form should be emailed to Patty Towler at ptowler@nsbn.state.nv.us with the NV State Board of Nursing.

This Protocol will update your license status from "Active Prescribing" to "Active Prescribing - CII-COLL"; this is the final APRN license status needed in order to have Schedule II Controlled Substances included on your DEA license.

Letter to the DEA Requesting Schedules 2 & 2N: please review the below information; this letter only applies if you are are an advanced practice registered nurse and your NV DEA does not reflect schedules 2-5.

If you are an advanced practice registered nurse and your DEA license issued before your state license reflects the "Active Prescribing - CII-COLL" status, your DEA will only list schedules 3, 3N, 4, and 5.

In order to have schedules 2 and 2N added to your DEA license, you will need to submit a request to the DEA once your state license reflects the "Active Prescribing - CII-COLL" status.

Please complete the below Letter to the DEA Requesting Schedules 2 and 2N and email to Jennifer.N.Zavestoski2@usdoj.gov for processing.

Download the Letter to the DEA Requesting Schedules 2 & 2N

Step 2: Nevada Standardized Credentialing Application

Point of Contact for Step 2: Medical Staff Services

New Provider Credentialing Checklists: Please take a moment to review the appropriate checklist based upon your credentials. This checklist will help you gather the information Medical Staff Services will be requesting in the coming weeks:

Pre-Application Portal - Submit by the date included on your Provider Onboarding Guide.

The Pre-Application Portal will assist Renown Medical Staff Services in providing you with the most appropriate set of instructions, application, and privileging criteria (if applicable). Please refer to the Provider Onboarding Guide for specialty-specific information that needs to be included in your Pre-Application Portal Submission.

Credentialing Application: You will receive multiple emails from the Renown Medical Staff Services team; separate emails are sent for security purposes. Use the password you receive to access the MSOW Portal and complete the online Nevada Standardized Credentialing Application within 14 days. Please upload all available supporting documents listed in the New Provider Credentialing Checklist with your completed Credentialing Application. Once Medical Staff Services completes the initial review of your submitted Credentialing Application, you will receive an email with a list of outstanding (missing) items that need to be provided as they become available in order for your file to be completed. Please submit these items to Medical Staff Services via email as they become available; you will not be able to go back into the Credentialing Application portal to upload items once you have formally submitted your Credentialing Application.

Primary Source Verification (PSV) & Hospital Privileges: Medical Staff will initiate Primary Source Verification for your file if your role requires Hospital Privileges. You must have an active NV state license, active DEA (DEA must be unrestricted, but can registered in any state), and PSV must be complete for your file in order to be placed on a monthly committee agenda Please note the month your file will need to go to Medical Staff Committee for final review in order to maintain your current start date; this month is included in your Provider Onboarding Guide.

Provider Enrollment & Payor Applications: Medical Staff Services will share your completed Credentialing Application with Provider Enrollment to begin working on preparing your Payor Applications for the various insurance panels you will need to be credentialed with. Please be aware you will receive a separate email from a Provider Enrollment Coordinator with your Payor Applications once they are ready for your review and signature. Your Payor Applications cannot be submitted by Provider Enrollment until you have an active NV state license, CS and NV DEA. If you are a Psychologist or Therapist, only a NV license is required. To maintain your start date from a credentialing perspective, your payor applications must be submitted a minimum of 30 days prior to your start date.

Medicare Enrollment and NPPES Update 

Please click the "Medicare Enrollment" link and follow instructions to assist our Payor enrollment Team manage your Medicare Enrollment process and update your NPI Registry. We use a surrogacy process (others appointed to act on your behalf) to manage your Medicare enrollment(s) and NPPES information using staff usernames and passwords . We maintain confidentiality keeping usernames and passwords private.

Step 3: HR Onboarding

Point of Contact for Step 3: Provider Recruiter

Please review the New Provider HR Checklist which contains important instructions for HR items to complete before and after your start date.

Internal Transfers:

  • New Provider HR Checklist Modifications: If you are a current Renown employee transferring from a non-provider role into a provider role, you will only need to complete the New Provider Paperwork outlined in Step 1 and Step 5 under the items to complete before your start date. Additionally, you do not need to complete any steps under items to complete after your start date.
  • Please note, your new operational leader will provide you with a copy of your provider onboarding/training schedule a minimum of 1 week prior to your transfer date.
  • You should also advise your current leader of your anticipated transfer date.

Step 4: UNR Med Joint Faculty Application

Point of Contact UNR Med Office of Community Facility 

As a Provider with Renown Medical Group, we ask that you apply for Joint Faculty appointment with UNR Med through the UNR Med Office for Community Faculty.

Please review the Joint Faculty Application Cover Sheet/Application following the provided instructions to submit your application. For questions, please contact their office directly or your Recruiter.