Health Care Providers
Certain uniform forms are required by the state of Maryland to be used by health care providers when submitting to insurance carriers. This section provides the requirements, instructions and the forms.
- Uniform Credentialing Form
October 7, 2009
Life and Health 09-25
- Maryland Uniform Credentialing Form
This is a large file which may take some time to open. This version may be filled out, printed and saved.
- CAQH Credentialing Form
The credentialing form of CAQH may be used.
Uniform Treatment Plan
- Uniform Treatment Plan Instructions
- Maryland Uniform Treatment Plan Form
This version may be filled out and printed.
Form to be used by regulation: COMAR 31.10.21.02-1H effective 5-11-15.
Maryland Uniform Dental Consultation Referral Form
- Maryland Uniform Dental Consultation Referral Form
Form to be used by regulation: COMAR 31.10.12 effective 1-1-05