Provider Intake Process

To maintain compliance and ensure appropriate alignment, all interested providers must complete a confidential intake and credential review.

Provider Intake Includes:

Active professional license(s)

State(s) of practice Scope of services provided

Practice setting and business structure

Proof of required certifications and training

Professional liability insurance

Submission of an intake form does not guarantee acceptance or delegation.

All partnerships are subject to review, state eligibility, and formal agreement.