Below is a list of specific requirements contained within the online application, as well as OTHER requirements SEPARATE FROM and ADDITION TO your online application. ALL must be completed for your credentialing application to be considered complete. Please review the list below CAREFULLY, as some requirements apply only to MDs, only to Allied Health practitioners, or both.
UCLA Health requires healthcare providers to complete a number of Training Modules at the time of initial application and reappointment. There are different training modules required depending on:
1) The specific UCLA Health entity(s) to which you are applying
2) Your provider “type” (e.g. MD, Nurse Practitioner),
3) Whether you are undergoing initial or reappointment credentialing
To determine which training modules are required for your application, and to access all training module links, select the TRAINING link above on the top menu bar.
If you believe you have recently completed the modules (within the past 12 months), please fax your certificates of completion to (424) 291-4443 or upload directly onto the online application. Your results may not have been registered in the HR system accessed to verify completion of training modules.
MEDICAL STAFF/ ALLIED HEALTH TUBERCULOSIS-SCREENING (TB)
All healthcare providers undergoing initial or reappointment credentialing must complete TB screening AND submit a TB questionnaire. The questionnaire may be accessed at http://ohs.uclahealth.org/tuberculosis-screening. If you need to make an appointment for a TB test, please contact Occupational Health: http://ohs.uclahealth.org/. (INITIAL APPLICANTS: You must be officially hired by your department AND be issued a UCLA ID Badge prior to making a TB appointment. You will be asked to show your UCLA Badge at your appointment). You may also submit recent TB results (within one year from the time of application) from a non-UCLA facility. When available, fax both your questionnaire and TB/Quantiferon results to (424) 291-4443, Attn: Credentialing Verification Office, OR email to: [email protected] You may also upload both within your online application.
NOTE: This TB Requirement also applies to Community (Courtesy) physicians who are not UCLA employees. For questions regarding TB clearance, contact Occupational Health at 310-825-6771.
Continuing Medical Education hours are required every two years. Submission of actual CME hours are not required. However, a question on the online application will ask you to attest that you have completed the hours required to maintain your medical license, along with a brief listing of the activities.
It is also not necessary to record CME hours if you recently completed a Residency or Fellowship. Please indicate on the CME question on the online application: “I recently completed/will complete a Residency/Fellowship program.”
Privilege Form: You will request or re-request specific procedural privileges for your department as part of the online application. If you believe the incorrect privilege form was included on the online application, reach out to your medical staff office contact or your Department Chair for more information.
Privilege Categories: Category-A core privileges are generally privileges that require completion of a Residency only. Category B and C privileges generally require advanced training, such as an ACGME accredited Fellowship, board certification, or other advanced training. Should you need more assistance completing your privilege form, contact the Medical Staff coordinator for your department. For members already on staff, you may view your current privileges at https://www.uclahealth.org/medical-staff/privileges (UCLA AD Account access only).
Moderate Sedation Privileges: If you are requesting moderate sedation privileges for the first time, you must take a moderate sedation quiz. Go to the TRAINING link on the top menu bar above, and select Moderate Sedation for more information. A certificate of completion is required to be granted this privilege. For providers undergoing reappointment, documentation of moderate sedation cases OR a certificate of completion of the aforementioned quiz is required for renewal. If you elect to submit cases rather than take the quiz, reach out to your Medical Staff coordinator to obtain a submission form.
SANTA MONICA BACKUP COVERAGE (UCLA-Santa Monica Providers ONLY)
On the online application, you will be asked to list a covering physician on the Santa Monica Backup Coverage. The covering physician is usually a colleague who is willing to provide backup coverage for you. Please contact the UCLA-Santa Monica Medical Staff Office at (424) 259-9531 should you have a question regarding whom to list.
JOB DESCRIPTION/PERFORMANCE EVALUATION (Nurse Practitioners Only)/PA DELEGATION AGREEMENT (Physician Assistants Only)
The following Advanced Health Care Practitioners require JOB DESCRIPTION/PERFORMANCE EVALUATION (NPs, PAs, CRNAs, CNM ONLY) and PA DELEGATION AGREEMENT (Physician’s Assistant ONLY) when applying for hospital privileges at appointment and reappointment: