Join Our Network
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 should be sent to [email protected].
Upon review and approval of your request you will be sent a 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 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 – Nevada
- Letter of Intent – Texas
- Standardized Credentialing Application – Nevada
- Standardized Credentialing Application – Texas
- Credentialing Instructions
- Provider Profile Sheet
Please note that all claims received for services provided to a Prominence Health Plan member 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.