Join our Prominence provider network and help us work toward creating healthier communities.

New Provider/Practitioner

If you would like to join the Prominence network, please complete our Letter of Intent. You must include a current W-9 with your request.

Letter of Intent

Upon review of your request by the Prominence Contracting Department, you will be asked to submit additional information to begin the credentialing and contract processes.

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 partners with CAQH ProView. To begin the credentialing process we ask that you first create a free CAQH account and provide the CAQH number.

Learn more about CAQH 

To add new providers, you can submit the online form via our secure Prominence Provider portals:

Medicare Advantage Secure Provider Portal 

Commercial/ASO Secure Provider Portal 

Provider Resources

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. You may download the forms below.

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.

Download Forms

W-9

Standardized Credentialing Application – Nevada

Standardized Credentialing Application – Texas

Credentialing Instructions

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.

Contact Us

If you have any questions, please contact a friendly Prominence team member within one of our departments below and we’ll be happy to assist you.

Provider Relations
833-863-0323
Fax: 775-770-9006
[email protected]

Provider Credentialing
Fax: 775-770-9016
[email protected]

Provider Contracting
Fax: 775-770-9009
[email protected]

For Providers

Join a network within Prominence Health Plan and help us work toward creating a healthier community.

New Provider/Practitioner

If you would like to join the Prominence network, please complete our Letter of Intent. You must include a current W-9 with your request.

Letter of Intent

Upon review of your request by the Prominence Contracting Department, you will be asked to submit additional information to begin the credentialing and contract processes.

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 partners with CAQH ProView. To begin the credentialing process we ask that you first create a free CAQH account and provide the CAQH number.

Learn more about CAQH 

To add new providers, you can submit the online form via our secure Prominence Provider portals:

Medicare Advantage Secure Provider Portal 

Commercial/ASO Secure Provider Portal 

Provider Resources

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. You may download the forms below.

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.

Download Forms

W-9 

Standardized Credentialing Application – Nevada 

Standardized Credentialing Application – Texas 

Credentialing Instructions 

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.

Contact Us

If you have any questions, please contact a friendly Prominence team member within one of our departments below and we’ll be happy to assist you.

Provider Relations
833-863-0323
Fax: 775-770-9006
[email protected]

Provider Credentialing
844-484-2824
Fax: 775-770-9016
[email protected]

Provider Contracting
Fax: 775-770-9009
[email protected]