Coordinated Care HealthContract Materials
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You will be able to view things like:
- Member benefits and eligibility
- Submit claims & review payment history
- The PCP panel (patient list)
- Member gaps in care
- And more!
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- Release of Information Form
- Washington Instructions For Completing Provider Agreement
- Washington Practitioner Application
- Practitioner Application: Attachment A – Ownership & Control Disclosures
- Blank W-9 Form
- Cover Letter for Ancillaries
- Cover Letter for Groups and Clinics
- Cover Letter for Hospitals
- Credentialing Application Packet
In order to receive the Contract and Credentialing documents necessary to become a provider, please contact us.