* The provider agreement and Exhibit 1.1 are legal documents. Please do not modify them in any way. Any changes should be made on separate correspondence.
Payment of UniNet dues and credentialing fees must be received before a file can be reviewed. Please return above mentioned documents and payment directly to UniNet Healthcare Network.
When completing the application, please include the following information in order to avoid delay in the credentialing process:
If there have been any malpractice issues, including but not limited to pending, settled cases or dismissed cases, please include a detailed, written explanation. Applications often are delayed due to lack of appropriate information regarding malpractice claims.
Please return the completed application and all supporting documentation directly to CHI Health Centralized Credentialing. Contact information will be included with your packet.
Questions? Please email our credentialing department.