Provider Criteria

  1. Applicant must agree to abide by all contract terms and operating policies.
  2. Applicant must be licensed by the State of Wisconsin and in good standing with their respective examining board.
  3. Applicant must provide proof of state-required malpractice and general liability insurance.
  4. Applicant must be credentialed by St. Agnes Hospital, Aurora Health Network, or another credentialing body approved by FABOH.
  5. Applicant must also provide a list of other hospitals where the individual currently has staff privileges.
  6. Applicant must provide services from a location in Fond du Lac; and
    1. Applicant must provide 24-hour call or back-up coverage in Fond du Lac;
      or
    2. Applicant must be sponsored by a local provider organization
      Note: An exception may be made when a service is not available in Fond du Lac County and/or is sponsored by a FABOH provider.
  7. Applicant must agree to protocols and medical management plan and make referrals to providers within the network whenever possible.
  8. Non-medical provider applicant must provide proof of medical oversight for acceptance to FABOH by an M.D. with staff privileges at St. Agnes Hospital or any other hospital to which the individual currently has privileges.

Note: FABOH reserves the right to contract with providers and modify the criteria based upon the needs of its members.