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Credentialing spreadsheet template

Credentialing spreadsheet 2026

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The document outlines the process for credentialing changes at a Medical Test Site (MTS), including a Credential Status Change Form for updating contact information and facility details. It specifies qualifications required for personnel overseeing moderate and high complexity testing, detailing acceptable credentials for laboratory directors and clinical consultants. The form must be signed by the MTS Director to certify the accuracy of the provided information.

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Click ‘Get Form’ to open the credentialing spreadsheet in the editor.
Begin by entering your information in the 'Your Information' section. Fill in the MTS Name, Effective Date of Change, and MTS License #.
Indicate the type of change you are making by checking the appropriate box for Address Change (current address), and provide the new address details including City, State, and Zip Code.
Update contact information by entering new phone and fax numbers, as well as any changes to facility names or laboratory contacts.
For qualifications of personnel, check only one option for both Moderate and High Complexity Testing Directors based on their credentials. Ensure all relevant fields are completed accurately.
Finally, sign and date the form at the bottom to certify that all provided information is accurate before submitting it.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (189 Votes)
2016	4.3 Satisfied (274 Votes)
2014	4.4 Satisfied (553 Votes)
2012	4.2 Satisfied (61 Votes)

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What is an example of credentialing?

Examples of Credentialing Documentation. Completed using government-issued picture identification. Completed using government-issued picture identification. Primary source verification directly from the state licensing agency/body.

What is credentialing data?

The provider credentialing process begins with collecting detailed information about a healthcare providers qualifications. This includes their educational background, professional licenses, certifications, work history, malpractice history, and disciplinary actions.

How do you do credentialing?

Credentialing begins with the collection of essential documents and data, including educational certificates, licenses, residency completion records, and work history. Providers are also required to submit docHubd government-issued identification, malpractice history, and sometimes criminal background checks.

How to make a professional looking spreadsheet?

hide grid lines. Use borders. Use consistent font. Use consistent number formatting. Use consistent alignment. Bold or highlight what you want the reader to focus on.