Welcome to Mercy Health! We are pleased to have you as part of our team. On the first day of your Onboarding process, we ask that you complete and submit ALL forms to your Human Resources Specialist.
All forms/documents are in Adobe PDF format. If you experience difficulties downloading/opening any of these files, try installing Adobe Reader®.
Primary Contacts
Following are your primary contacts to help you successfully complete the required paperwork and tasks:
Payor Credentialing:
Casey Roark, CPMSM
4600 McAuley Place, ML 05047
Cincinnati, OH 45242
513-981-6643
Email
Malpractice Coverage:
Lori Knauf, Regional Manager
Legal/Loss Prevention Services
4600 McAuley Place
Cincinnati, OH 45242
513-981-6283
Email
Please return the information sheet, attachments and the following forms to Casey Roark:
The following documents need to be read, printed, signed and returned to Lori Knauf:
Catholic Health Partners Medical Professional Liability Insurance Applications Physicians and Surgeons
Initial Credentialing Onboarding Needs
Standard Care Arrangement-CNP 2-24-2012
Letter to Phys-Intro to PRMP 1-18-2012
Claims Made Documentation 1-18-2012
Initial Participation and Education Requirements for FP and IM 11-22-2011
Initial Participation and Education Requirements for Surgeons 11-22-2011
Initial Participation and Education Requirements for Obstetricians 11-22-2011
Malpractice Application for Physician Revised 4-1-2012
Please visit Resources & Medical Staff Services to contact the Medical Staff Office to request an application for medical staff membership/privileges.
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