(A) Pursuant to rule 4123-6-021 of the Administrative Code, the bureau shall mail each provider a provider application, which shall require the provider to furnish credentialing documentation as provided in rule 4123-6-022 of the Administrative Code.
(B) The provider application may require the provider to make statements that the provider is without impairments that would interfere with the provider's ability to practice or that would jeopardize a patient's health, and a statement that the application is without misrepresentation, misstatement, or omission of a relevant fact or other acts involving dishonesty, fraud, or deceit. The provider shall provide to the bureau any additional documentation requested, and must permit the bureau, upon reasonable notice, to conduct a review of the provider's practice or facility.
(C) The bureau shall review the application and credentialing documentation submitted by the provider. The bureau shall cross-check data with other governmental agencies or licensing bodies.
Effective date: Feb. 16, 1996