Become an Allegian Health Plans Network Provider
Thank you for your interest in becoming a network provider with Allegian Health Plans. We welcome quality providers to join our network, and our goal is to give your patients high-quality, safe and cost-efficient health care. We offer HMO, PPO, self-funded and Choice (ACA Marketplace) products.
Allegian Health Plans evaluates each provider’s request for participation based on the needs of our membership within specific geographic areas. To apply for participation, please follow the steps below. If you have any questions, please contact Provider Contracting at (877) 422-4400 or by email at PHPNetworkManagement@abrazohealth.com.
Download and complete the appropriate form(s). You may email the completed forms to the email address above.
- For physicians and practitioners, please complete the following form
For organizational providers, please complete the following two forms
Email, mail or fax the completed forms to Network Development
An Allegian Health Plans representative will contact you with contract information prior to the credentialing process.
Allegian Health Plans uses the CAQH credentialing application for providers. If you are a first-time CAQH user, CLICK HERE for the Quick Reference Guide.
All data submitted by providers through Universal Provider Datasource (UPD) is maintained by CAQH in a secure, state-of-the-art data center. Providers grant health plans and other organizations access to the information. Providers needing more information about registering with the service or completing the UPD application should visit https://upd.caqh.org/oas/ or call the CAQH Provider Help Desk at (888) 599-1771.
Note: If your application includes a CAQH number, please make sure your information is current.
Credentials Verification Organization (CVO)
Allegian Health Plans uses Conifer Health Solutions, an NCQA Certified CVO, to credential all providers. You will receive correspondence from Conifer Health Solutions requesting that you complete or update a credentialing application and/or provide additional documentation in order to complete your application process. Any requests from the CVO are legitimate and vital to the timely completion of your initial credentialing or recredentialing event.
NOTE: Each participating plan retains the right to make their own contracting decisions (whether or not to add practitioners and facilities to their network) and will make their own credentialing committee decisions (review of the primary source verification information obtained by the CVO resulting in approval/denial by the plan's committee).
The credentialing process at Allegian Health Plans is:
- Verification of a completed Texas Standardized Credentialing Application through CAQH
- Presentation of a complete and verified application to the Quality Management Council for approval
- Full execution of the contract by both parties
- The provider is loaded in our claims processing systems
- An effective date is assigned
- A Welcome Letter will be sent to you with an effective date, along with a copy of the executed contract