Join Our Network

  • One of the best ways we can serve our customers is by ensuring access to a high quality provider network.

    How to apply

    You can request an individual contract or join one of our contracted independent practice associations or medical groups. In either case, you must also meet our credentialing criteria:

    • Complete the Alaska medical or dental application, attestation, and release forms
    • Send your completed application with copies of the following documents:
      • Current DEA certificate or coverage plan for the state in which you're practicing
      • All current state licenses
      • Current professional liability insurance certificate
      • Completed W-9
      • Any explanations to “Yes” answers on your credentialing application

    View all credentialing forms

    How to avoid delays

    The top reasons for incomplete applications include:

    • Incomplete address, suite number, or phone number
    • Missing tax ID number
    • Missing W-9s on new contracts
    • Expired malpractice insurance
    • Incomplete or missing work history or education information
    • Hospital privileges, if applicable

    View our provider credentialing checklist to make sure your application is complete.

    Submit by mail, fax, or email

    PO Box 327 - MS 263
    Seattle, WA 98111-0327

    Fax: 425-918-4766


    Contract acceptance

    Your acceptance is based on application information and network requirements. Please be aware that the credentialing process typically takes 60 to 90 days. If your submitted application is complete and you're accepted, you'll receive a counter-signed contract and start date. For all Premera plans, you can't see members under the contract until you're officially credentialed. Also, your malpractice insurance must start before credentialing is complete.

    For more information

    For more information about our selection criteria and credentialing standards, contact Physician and Provider Relations.