How to apply

Step 1

Complete the application, based on your practitioner type:

Unsure of your practitioner type or which application to submit? Refer to our Practitioner List.

Step 2

Include all required documents along with your application. A checklist is located within the application.

Step 3

Email the application and all required documents to the following. Please note a request to participate does not guarantee that you will receive a contract.

Get Help

Questions about our contracting or credentialing process?

For assistance please use:

Contact Us form

Update Practice Information

Help us maintain accurate provider directories and ensure members can find your practice.

Go to Update Practice Information  or complete a Practitioner Demographic Change Form .