Step 1: Receive notification of provider accepting positions with Munson Healthcare.

Step 2: Compete and fill out Provider Request Form. Submit to appropriate Medical Staff Office. 
Hospital credentialing/payer enrollment takes 90-120 days to complete once all requirements are met for full enrollment. Submit this form as soon as possible to avoid delays. 

Step 3: Review Provider Onboarding Checklist. This checklist is a basic overview of tasks that may need to be complete. It is recommended to down this list and add onboarding details related to the specifics of your clinic to use for future onboarding. 

Step 1: Ensure appropriate resources are available at outreach/new service location. Examples: EMR builds, billing, staffing, regulatory, and supplies. 

Step 2: Compete and fill out Provider Location Addition or Change Request Form. Submit to appropriate Medical Staff Office. 

NOTE: Hospital credentialing/payer enrollment takes 90-120 days to complete once all requirements are met for full enrollment. Submit this form as soon as possible to avoid delays.  

Step 1: Ensure notification has been sent to Andrea Ludka, Lisa Giovanelli, Kara Classens, Jeff Klug, Jamie Buning, Local Medical Staff Office, and Human Resources.

Step 2: Compete Provider Resignation Form and submit to the appropriate Medical Staff Office. 

Step 3: Review Offboarding Checklist. This checklist is a basic overview of tasks that may need to be completed. It is recommended to download this list and add onboarding details related to the specifics of your clinic to use for future offboarding. 

• Provider Request Form
• Provider Onboarding Checklist
• Add MPN Provider to Press Ganey
• On-Call Paging Parameters
• PA Practice Agreement
• NP, CNM Practice Agreement
• NP, CNM Prescriptive Authority Delegation
• CRNA Practice Agreement
• Cadillac Hospital – The Importance of Being Up to Date
• Charlevoix Hospital – The Importance of Being Up to Date
• Grayling Hospital – The Importance of Being Up to Date
• Kalkaska Memorial Hospital – The Importance of Being Up to Date
• Manistee Hospital – The Importance of Being Up to Date
• Munson Medical Center – The Importance of Being Up to Date
• Otsego Memorial Hospital – The Importance of Being Up to Date
• Paul Oliver Memorial Hospital – The Importance of Being Up to Date

• Provider Resignation Form
• Offboarding Checklist
• Remove MPN Provider from Press Ganey