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

New Provider/Practitioner

Join a network for commercial providers or access administrative forms, claim information, advanced directives and other resources.

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.

Notice to Texas Physicians and Providers

Prominence HealthFirst of Texas, Inc., located at 1510 Meadow Wood Lane, Reno, NV, 89502, a Health Maintenance Organization (HMO), will accept written applications for participation in their network during the period of March 1, 2020 through March 21, 2020. Physicians and providers must apply during this period and must meet practice standards, qualifications and other participatory criteria established by the HMO.

To request participation, please write to:

Prominence Health Plan
Attn: Texas Provider Network Inquiries
1510 Meadow Wood Lane
Reno, NV 89502

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.

Download Forms

Letter of Intent – Nevada 

Letter of Intent – Texas 

W-9 

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.

Contact Us

Provider Relations
775-770-9270
Fax: 775-770-9006
[email protected]

Provider Credentialing
775-770-9251
Fax: 775-770-9016
[email protected]

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

Join Our Network

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

New Provider/Practitioner

Join a network for commercial providers or access administrative forms, claim information, advanced directives and other resources.

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.

Notice to Texas Physicians and Providers

Prominence HealthFirst of Texas, Inc., located at 1510 Meadow Wood Lane, Reno, NV, 89502, a Health Maintenance Organization (HMO), will accept written applications for participation in their network during the period of March 1, 2020 through March 21, 2020. Physicians and providers must apply during this period and must meet practice standards, qualifications and other participatory criteria established by the HMO.

To request participation, please write to:

Prominence Health Plan
Attn: Texas Provider Network Inquiries
1510 Meadow Wood Lane
Reno, NV 89502

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.

Download Forms

Letter of Intent – Nevada 

Letter of Intent – Texas 

W-9 

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.

Contact Us

Provider Relations
775-770-9270
Fax: 775-770-9006
[email protected]

Provider Credentialing
775-770-9251
Fax: 775-770-9016
[email protected]

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