Provider Credentialing Applications and Policies
Prospective Alliance providers are required to complete the appropriate credentialing application. You can find provider credentialing applications and policies below.
If you are unsure of which application to complete, please submit an Application Request form. Our Provider Services Department will contact you to confirm which of the following applications to use.
Credentialing Applications
Credentialing Policies
300-4020 - PRCC Authority Rules and Responsibilities
300-4030 - Credentialing Criteria and Identified Issues
300-4040 - Professional Provider Credentialing Guidelines
300-4060 - Credentialing Review of Facility Site and Medical Record Keeping Audits
300-4090 - Ongoing Monitoring of Provider Credentials and Issues
300-4102 - Reporting to the MBC and NPDB
300-4103 - Fair Hearing Process for Adverse Decisions
300-4110 - Organizational Providers Credentialing Guidelines
300-4130 - HIV/AIDS Specialist Identification and Monitoring
300-4150 - Contract Changes for Currently Credentialed Providers
Contact Provider Services
| General | 831-430-5504 |
| Cov Kev Thov Billing questions, claims status, general claims information |
831-430-5503 |
| Authorizations General authorization information or questions |
831-430-5506 |
| Authorization Status Checking the status of submitted authorizations |
831-430-5511 |
| Lub Tsev Muag Tshuaj Authorizations, general pharmacy information or questions |
831-430-5507 |
Provider Resources
Latest Provider News
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