By completing this form, you are attesting to meeting the standard medical policy requirements as required by all in-network providers.
Credentials and licensure will be verified during the credentialing process which begins after network participation approval.
All contracted providers are required to register with Availity Essentials to submit claims electronically and receive claims payments via electronic funds transfer (EFT). Facilities are encouraged to use Availity Essentials to view pre-authorization requirements and submit requests.
Learn more about tasks required as part of the onboarding process.