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Join Our Participating Provider Network

We're glad to hear that you are interested in joining the HealthLink network. We have a diverse network of exceptional healthcare professionals that help to ensure our members have uninterrupted access to the healthcare they need. We make getting started easy with our online application process.

HealthLink uses CAQH (Council for Affordable Quality Healthcare) ProViewTM to collect and verify healthcare professional's qualifications, including certification, training, licensure, and registration to practice. If you have a CAQH user ID, please make sure to give HealthLink authorization to view your CAQH credentialing information. For help with you can contact CAQH at 888-599-1771. Our Program Summary includes a complete list of provider types we credential and those we do not.

As part of the contracting process each physician, hospital and other healthcare provider must satisfy the applicable selection standards before he or she is eligible to apply for participation in one or more of HealthLink's programs or networks. Please review HealthLink Standards of Participation prior to completing the below form.

Please note submitting the application does not guarantee the practitioner will become a participating HealthLink provider or facility. The contracting and credentialing process can take 90-120 days.

Type of Request
Requestor Information
Provider Information
Last Name and Suffix, First Name, Middle Initial, and Provider Degree - MD, DO, PhD, etc.)
Hospital Privileges
Malpractice Coverage
Primary Office Address
Secondary Office Address
Billing Address