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Provider Credentialing and Licensure Steps

Congratulations on becoming a Renown Health provider!

We are excited to have you on board!

This portal is designed to help you navigate through the onboarding process in chronological order and provide you with detailed completion instructions for important applications, forms, as well as anticipated deadlines for completion, to ensure your start date remains on track. If you need any assistance along the way, don’t hesitate to contact your Provider Recruitment Coordinator.      

New Provider Checklist

Please take a moment to review the appropriate checklist based upon your credentials. This checklist will help you gather the information we will be requesting in the coming weeks.   

New Provider Onboarding Requirements

Step 1: Nevada Licensure Applications (Complete within 7 days)

Nevada Licensure Application

 

Controlled Substance (CS) Application 

  • Physician Application - Print and mail the following items to the Board of Pharmacy. If your state license is pending, leave “Practitioner License Number” blank.
  • APRN Application - If you need a Collaborating Physician per Nevada State Board of Nursing Board requirements, print and mail the following items to your Provider Recruitment Coordinator for submission. If you do not require a Collaborating Physician, please print and mail the following items directly to the Board of Pharmacy. If your state license is pending, leave “Board of Nursing APRN Certificate #” blank.
  • PA Application - All PA Prescribe applications require the original signature of the Supervising Physician. Print and mail the following items to your Provider Recruitment Coordinator for submission. If your state license is pending, leave “Medical/Osteopathic Board PA#” blank.

$200 Registration Fee – must be personal check or credit card (credit cards are charged 5% processing fee)

 

DEA Licensure

During your initial onboarding call with your Provider Recruitment Coordinator, you will discuss whether you will need to apply for a new DEA or transfer the address on your existing DEA to ensure you meet the necessary deadlines for credentialing.

New DEA Registration: Once your application is processed, the Board of Pharmacy will issue you a pending registration number to apply for a new DEA. Please note: you will not receive your pending registration number until you have an active state license in Nevada.

Once you have received a copy of your DEA certificate with NV address, please send a copy to the Nevada State Board of Pharmacy. You will then be able to apply for a Nevada Prescription Monitoring Program (PMP) account. Instructions for the PMP application are included in Step 3 of the Nevada State Board of Pharmacy Controlled Substance Application. Once your PMP application has been approved, the Nevada State Board of Pharmacy will issue your Controlled Substance (CS) license.  

 

Collaboration Agreement Forms

Note: The Collaboration Agreement Forms only apply to Advance Practice Providers (APPs).

The original forms must be mailed to:
Renown Health
Attention: Provider Recruitment
1155 Mill St., Mailstop O8
Reno, NV 89502

Important: The completed form may not be returned via fax or email. Original signatures are required for processing.

 


Step 2: ROI, ACO, and CIN Forms (Complete within 10 days) 

Please print, sign, and email forms directly to you Provider Recruitment Coordinator.

  • Release of Information - The Release of Information will initiate your HR background check.
  • ACO Consent - As an ACO, Renown is committed to providing the highest quality of care at the lowest possible cost, while ensuring a positive patient experience.
  • CIN Agreement - Clinical Integration Network Participating Provider Agreement. The Western Clinical Alliance is a Clinically Integrated Network (CIN) which joins together health system employed and private practice physicians, across our community and in collaboration with Renown Health and other care providers, into a single comprehensive care delivery network, with a shared, common set of goals focused on increasing value by improving outcomes and better managing the total cost of care for patients. 

     


    Step 3: Nevada Standardized Credentialing Application (Complete within 14 days)

    The Pre-Application Portal will assist Renown Professional Staff Services in providing you with the most appropriate set of instructions, application, and privileging criteria (if applicable).

    You will receive five emails from the Renown Medical Staff Services team. Separate emails are sent for security purposes.

    Use the password you receive to access the MSOW Portal and complete the online Nevada Standardized Credentialing Application. Please upload all supporting documents listed in the New Provider Onboarding Checklist with your completed Credentialing Application.

     


    Step 4: HR Onboarding and Employment Physical (30 days prior to start date)

    New Employed Provider Quick Checklist

    • Please review the checklist as it contains instructions for items to complete before and after your start date.
    • Items can start roughly 30 days prior to New Employee Orientation

    Download Checklist (pdf)

     

    Occupational Health Appointment

    Contact Occupational Health to schedule your Pre-employment Physical for approximately 2 weeks prior to your New Employee Orientation Date.

    • Appointment must be a minimum of one week prior to your start date and cannot be more than 30 days prior to your start date
    • Once your appointment is scheduled email your Provider Recruitment Coordinator with the date and time of the appointment
    • You can create an account through MyChart to access your records from your Pre-Employment Physical.
    • If applicable please email your TB Test and proof of Flu Vaccine to your Provider Recruitment Coordinator

    Plan for a 2-hour appointment, which includes: