Join Our Network

  • Notice: Effective April 21, 2021, all boroughs in Alaska are closed to accepting new providers for durable medical equipment (DME) and freestanding laboratory. We review this semi-annually and will update this page with changes.

    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 SS-4 IRS confirmation letter
      • 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 SS-4 IRS confirmation letter 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


    What happens next

    The credentialing process typically takes 60-90 days.

    Acceptance is based on your application information and network requirements. If your submitted application is accepted.

    • New provider joining our network: You'll receive a contract to review and sign through DocuSign. Once you return your signed contract, you'll receive a counter-signed contract through DocuSign with your participation effective date.
    • New provider joining an existing contracted group/clinic: You’ll receive a letter with your credentialed date, and you’ll be added under the group/clinic’s location(s) as a credentialed provider.

    For all Premera plans, you can't see members until you're officially credentialed under contract. Also, your malpractice insurance must not expire before credentialing is complete.

    For more information

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