Complete Credentialing and Contracting, Sole Provider Sign Up

Thank you for your interest in our lactation provider Complete Credentialing Service. This service takes you from the database (CAQH or Provider Source) all the way through the contracting process with the insurance company you choose. (You’ll be able to discuss specifics with your credentialing specialist.) Please complete the contact information below. After submitting this information, you’ll be directed to a page to complete payment, depending on the service you choose. You can choose one or more insurance companies–Note: you do not have to select the database with this form. 

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Fax:
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Payment

Please select the service you would like (1 payor or 2 payors) and click Submit.  You will be directed to Paypal to complete your payment.

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If you know which database and payors you're signing up for, please enter them here.
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