Provider Healthplan Enrollment
Five Steps to Health Plan Enrollment:
- Apply for your NPI
- Complete the three (3) page questionaire
- Answer the Brown & Toland "Yes" or "No" questions
- "Submit Via Email"
- Print all documents and sign all signature pages
- Include legible photocopies of necessary attachments, NPI confirmation email and foward to
your department credentialing contact.
Completion of this application will take around 20 minutes, if you have
questions please contact
us via email or call 415.476.4007.
Physicians/Medical Doctors
(MD's)
Allied Health Care Professionals
(i.e. NP's, CNP's, RN's, PA's, PhD's...)
It is recommended that provider enrollment be completed
using the Adobe Acrobat applications because it requires fewer steps.
However, if you don't have © Adobe Acrobat
functionality on your computer you may wish to use the ©
Microsoft Word 
versions.
Adobe Acrobat Alternative
|
