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Join Our Network

May 21, 2020

One of the best ways we can serve our customers is by ensuring access to a high-quality provider network.

How to apply

You can request an individual contract or join one of our contracted independent practice associations or medical groups. In either case, you must also meet our credentialing criteria.

Send your completed application with copies of the following documents:

  • Current DEA certificate or coverage plan for the state in which you're practicing
  • All current state licenses
  • Current professional liability insurance certificate
  • Completed W-9
  • Any explanations to “Yes” answers on your credentialing application

View all credentialing forms

How to avoid delays

The top reasons for incomplete applications include:

  • Incomplete address, suite number, or phone number
  • Missing tax ID number
  • Missing W-9s on new contracts
  • Expired malpractice insurance
  • Incomplete or missing work history or education information
  • Hospital privileges, if applicable

View our provider credentialing checklist to make sure your application is complete.

Submit by mail or fax

Mail:
PO Box 327 - MS 263
Seattle, WA 98111-0327
Fax: 425-918-4766

What happens next?

The credentialing process typically takes 60-90 days. Acceptance is based on your application information and network requirements. If your submitted application is accepted.

  • New provider joining our network: You'll receive a contract to review and sign. Once you return your signed contract, you'll receive a counter-signed contract and the effective date of your participation.
  • New provider joining an existing contracted group/clinic: You’ll receive a letter with your credentialed date, and you’ll be added under the group/clinic’s location(s) as a credentialed provider.

For all LifeWise plans, you can't see members until you're officially credentialed under contract. Your malpractice insurance must not expire before credentialing is complete

For more information

For more information about our selection criteria and credentialing standards, visit the LifeWise credentialing website.

Need secure website access?

Registration is easy and free. Go to OneHealthPort and select the Register tab in the Single Sign-On section. If you need help with your OneHealthPort account, call 800-973-4797.