If you’re newly licensed as a different provider type, you will need a new contract. Submit the appropriate contracting application.
For changes related to your clinical profile in our provider directory, complete the clinical profile form.
|For changes related to||You should|
||Complete the Contract Update Form for your provider type.|
||Submit a Standardized Provider Information Change Form.|
||Update your CAQH ProView record or submit a Standardized Provider Information Change Form.|