Skip to main content

Provider ResourcesPayer ResourcesFind a Provider
State Credentialing Forms

Providers in the states listed below may use their state’s form in place of the MultiPlan form for initial credentialing when applying to join our networks or for recredentialing purposes. The forms are posted below for your convenience. (Note that to apply to join our networks, these forms must be accompanied by a completed and signed MultiPlan provider contract.)

For questions about our credentialing process or joining our networks, call our Service Operations Department at 800-950-7040.

Arkansas Initial credentialing  Arkansas recredentialing 
 
Colorado initial credentialing   
District of Columbia initial credentiali  Districk of Columbia recredentialing
 Illinois initial credentialing  Illinois recredentialing
 Kansas initial credentialing  
Kentucky initial credentialing 1, 2, 3 Kentucky recredentialing
Louisiana initial credentialing  
Maryland initial credentialing Maryland recredentialing
Massachusetts initial credentialing  
Mississippi initial credentialing  
Missouri initial credentialing  
Nevada initial credentialing  
New Jersey initial credentialing New Jersey  recredentialing
North Carolina initial credentialing  
Ohio initial credentialing  
Oklahoma initial credentialing  
Oregon initial credentialing Oregon recredentialing
Texas initial credentialing  
West Virginia initial credentialing  recredentialing