New physician, provider, or clinic
New physicians, other providers, and clinics receive a W-9 form. The Internal Revenue Service requires completion of this form so we can report income. The W-9 form information must remain current at all times. If you make any change that affects the information on your W-9, you will need to complete another form immediately.
Once a physician or other provider completes the credentialing process, he/she will be set up in our payment systems.
Information/address changes
For physicians or other providers already credentialed and contracted with us, whenever there is a change in practice information (including adding a new location), please notify us in writing or complete the Contracted Provider Information Change/Update Form and return the form to Physician and Provider Relations. The form is available online.
Changes to your practice or remit address need to be reported in advance to ensure no interruption in reimbursement.