Allied Health Providers


Start the Credentialing and Contracting Application Process

View and download your specific credentialing application checklist and any additional forms and documents. Complete and submit the materials listed on each checklist according to the instructions below.


Ambulatory Surgical Center

Birthing Centers


Durable Medical Equipment (DME)

Family Planning

Home Health Agency

Hospice Agency

Imaging Facility

Inpatient and Outpatient Rehabilitation


Orthotics and Prosthetics

Sleep Centers

Skilled Nursing Facility

How to Submit Your Forms and Documents

You can submit your forms and documents by either emailing them to or by faxing them to 617.673.0909. To facilitate review of your application, please submit all materials together.

Rhode Island Based Providers Application Requirements

Effective January 1, 2018, a completed initial application will include a signed contract for all Rhode Island based providers. Any application submitted without a signed contract is considered incomplete and will not be credentialed until the contract is received.