Providers

Credentialing

At Trusted Health Plan™, we want to make sure that all of our care providers are accredited quickly and efficiently so that you can get back to caring for your patients. That is why we offer an expedited credentialing process. Fill out the simple form below and you will be contacted by one of our Credentialing Specialists about the next steps you need to take in the accreditation process.

Additional Credentialing Info

Please fill out the form below and one of our helpful staff will be contacting you shortly.

  • Country*
    0
  • First Name*
    1
  • Middle Initial*
    2
  • Last Name*
    3
  • Primary Specialty*
    4
  • Practice/Group Name*
    5
  • Office Phone #*
    6
  • Primary Contact Person*
    7
  • Address*
    8
  • Address Line 2*
    9
  • City*
    10
  • State*
    11
  • Zip Code*
    12
  • Email*(ex. email@domain.com)
    13
  • Confirm Email*(ex. email@domain.com)
    14
  • NPI*
    15
  • CAQH ID*
    16
  • Comments*
    17
  • 18
TRUSTED Health Plan (THP)

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Managed Care Organization (MCO)

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