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Credentialing Information


Minnesota Uniform Credentialing Application

In October 2001, a revised Minnesota Uniform Credentialing Application was approved by a group of users from hospitals, clinics and health plans, and is intended to be used by all credentialed practitioners - Physicians and Allied Health Professionals. The application was subsequently revised in April 2002.

Medica accepts either of these revisions of the uniform application (September 2001 or April 2002). Effective June 1, 2001, Medica will return applications submitted on a form other than one of these forms.

Reminders:

  • Please submit all credentialing applications to:
    Medica Credentialing Department
    Route CP412
    PO Box 9310
    Minneapolis, MN 55440-9310
    credinforequest@medica.com
  • Credentialing applications submitted to Medica must include an Authorization and Release naming Medica or Medica Health Plans as the entity.

Minnesota Uniform Credentialing Application
Authorization and Release
Medica Credentialing Plan

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