Join Our Network in Nevada
Join a network within Prominence Health Plan and help us work toward creating a healthier community.
If you would like to join the Prominence Health Plan network, please send a Letter of Intent to the Contracting Department detailing your interest in becoming a contracted provider. You must also complete a current W-9 with your request. Requests can be sent to the contact information listed on the form.
Upon review and approval of your request you will be sent a Nevada Standardized Credentialing Application (if you have not already submitted one) and contract information.
Existing Groups with New Practitioners
When adding a new practitioner to an existing group, it is imperative that you let the Contracting Department know as soon as possible about the addition. The credentialing process takes a minimum of 90 days to complete.
For credentialing, Prominence Health Plan uses the Nevada Standardized Credentialing Application. Also available are Credentialing Instructions. If you prefer, a copy of the application and instructions can be mailed, emailed or faxed to you at your request by contacting the Credentialing Department.
If you have any questions, please contact the Contracting Department.
- Letter of Intent (PDF) >
- W-9 (PDF) >
- Nevada Standardized Credentialing Application (PDF) >
- Credentialing Instructions (PDF) >
- Provider Profile Sheet >
Please note that all claims received for services provided to an HMO member, PPO member, or member accessing Preferred Health Care Network by a Provider/Practitioner who has not been credentialed and/or contracted with Prominence Health Plan will be denied or processed out-of-network as applicable.