Physician Services Form

If the Facility Administrator is not the Facility Owner, please complete section below.

Please include the name of individuals at your facility to be designated as Authorized System Users. These individuals will have access to an online NHI Bahamas system, the ability to access beneficiary information, submit service delivery claims/activity reports, and submit changes to facility data on behalf of the facility.

Please note that all facility staff who handle beneficiary information will need to participate in data privacy training, and will be required to provide proof of such training to NHI Bahamas.

If your facility is affiliated with another practice for continuity of care, please specify the facility name below. Please note that your affiliated practice will only be confirmed once they have registered under NHI Bahamas.

Please include a full listing of all primary care physicians working at your facility. All physicians listed will be contacted to confirm the information listed below. Please note that physicians are expected to show proof of malpractice insurance to register with NHI Bahamas.

Below you will be asked to list the hours per facility for each physician or the % full-time equivalent (FTE) spent at your facility for each physician. This is meant to capture the time allocation of physicians who may work at various facilities. Please note that NHI Bahamas considers 42 hours the standard for full-time in a week.

For example, if Physician 1 works a full work week split evenly between 2 facilities - you may enter 50% as % FTE, or 21 hours in the hours/week worked at facility. A physician who works 42 hours per week is eligible for a patient panel of 2000 patients.

For example, if Physician 1 works a full work week split evenly between 2 facilities - you would enter 21 hours in the hours/week. The % FTE will be 50% and that physician is eligible for a patient panel of 1000 patients.

If you would like to reduce your calculated panel size, please enter the number of patients here.
The number you enter must be less than your calculated panel size.

Please include a full listing of all nursing and allied health professions staff at your facility, who are registered by a local health professionals council/board.

All documents can be scanned and uploaded in this form, emailed to info@nhibahamas.gov.bs or presented upon inspection.