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Questions?
You can learn more about our network. Just call Provider Relations at 1-888-348-2922 (TTY: 711). We’re here for you 8:30 AM to 5 PM, Monday through Friday.
Why our network?
Why our network?
Whether you’re a physical or behavioral health care provider, we’ll work with you to understand your business and meet your needs.
When you take part in our provider network, you benefit from:
- Competitive compensation
- Ongoing support and learning opportunities
- Timely and efficient claims processing
- Advanced technology to help enhance patient care
- Dedicated support from us
Get all the answers you need from our communication materials, including the provider manual, newsletters and bulletins, emails, website notices, training kits and more.
We also help you:
- Track member information and updates
- Find forms
- Review claims or remittance advice
- Update changes to your practice
Your Provider Relations team
Your Provider Relations team
After you join our network, we’ll assign you a Provider Relations representative. They’ll be your primary point of contact with us, sharing important information with you. They’ll also help you with any admin or operational concerns, like tracking member information and updates, finding forms and reviewing claims or remittance advice.
Your Provider Relations representative will:
- Share our administrative policies and procedures
- Communicate changes and updates that help you in the efficient administration of our plans
- Advocate on your behalf to resolve issues
- Manage changes to your demographic information
Our Provider Relations representatives are based in the communities they serve, fostering personal relationships and a high level of responsiveness. They engage with providers in a variety of ways to provide proactive, prompt and collaborative communication.
You can also find answers in your provider materials, like your provider manual (PDF), notices and newsletters, training, emails and more.
Just complete the provider data sheet form (PDF) and email it to us. You can also fax it to 1-866-810-8476. Be sure to allow 7 to 10 business days to receive a response. If you have questions, you can call us at 1-888-348-2922 (TTY: 711).
Already sent us the form? If you’d like to check on the status of your application, just call us.
Qualifications that must be met for participation include:
- Coverage 24 hours per day, 7 days per week
- A current, valid state license to practice medicine
- Staff privileges at a participating hospital
- An active DEA certificate (if applicable)
- Verification of medical school completion, residency training and fellowship
- Verification of board certification (in specialty being practiced)
- Current professional liability insurance that meets state minimum requirements
- Acceptable professional claims liability history, including the National Practitioners Data Bank (NPDB)
The state requires uniform forms to be utilized in order to collect the credentials data commonly requested by health care entities and health care plans for purposes of credentialing and re-credentialing.
CAQH Universal Provider Datasource (UPD)
We are now accepting provider credentialing applications through CAQH (Council for Affordable Quality Healthcare) Universal Provider Datasource (UPD). This system is a national provider credentialing application initiative from the CAQH.
The easy-to-use, streamlined database is the single repository of participating health plans for health care provider information, alleviating the need for physicians and other health care providers to complete and submit many different credentialing forms for multiple health plans, hospitals and other health care organizations. More than 300,000 providers are now reducing paperwork and administrative costs through the UPD.