Providers

Become Part of Our Provider Network

Join a team dedicated to delivering quality healthcare to our community.

Start your credentialing process today and grow your practice’s reach.

Create your provider profile

Providers must complete the credentialing process through the Office of the Insurance Commissioner (OCI) portal.

Submit required documentation

Once the credentialing process is completed, submit the required documentation to the following email address:
[email protected]

ACH Form

Authorization form for electronic payments. A voided check or a valid bank certification must be submitted.

Ownership and Control Form

Form that identifies the ownership and control structure of the entity. It must be completed in full; if any question does not apply, indicate N/A.

W-9 Form

Tax form required for federal reporting and payment purposes. It must be completed and signed.

Contracting Request Form

Form used to request contracting with PSM. It must be completed with the required entity information.

For assistance and inquiries, you may contact our call center Monday through Friday, from 7:00 a.m. to 7:00 p.m.