| One
of the cornerstones of the Provider Alliance is selective risk
participation. Our strict underwriting standards ensure that
our members are quality-focused and dedicated to superior performance
and positive resident outcomes.
Program eligibility can be determined within 24-48
hours of receiving a complete submission. To determine
eligibility, please follow the instructions below:
| Determine Eligibility |
- Contact the Provider Alliance to get the name of an agent
in your area: 888-331-3305
- Click here to print and complete the ELIGIBILITY
FORM. All of the requested information must be provided
in order for your eligibility request to be processed.
- Fax a copy of the completed Eligibility Form along with
the following documents to the designated Provider Alliance
agent:
- CURRENTLY VALUED 5-YEAR LOSS RUNS (created within 90
days of your submission)
- Declaration page from the current or expiring policy
- You will be informed within 24-48 hours
on your eligibility status
- If you are eligible for the Provider Alliance, proceed
with the application
process; otherwise, your agent will discuss other options
that may be available to you.
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