First time logging into Provider Express
Below are links to our most frequently accessed forms
FREQUENTLY ACCESSED FORMS |
|
|---|---|
| Clinician Tax ID – Add/Update Online Form | Click Here |
| Clinician Tax ID – Add/Update Paper Form | Click Here |
| Clinician Tax ID – Add/Update - TennCare Medicaid Network only | Click Here |
| Optum Psych Testing Form (For KanCare, Medica and Unison Psych Forms, Click Here) |
Click Here |
| Wellness Assessment Form (Adult, English) |
Click Here |
| Individual Provider Disclosure of Ownership Form | Click Here |
| Clinician Specialty Attestation Form | Click Here |
| Agency Specialty Attestation Form | Click Here |
For all forms covering administrative, clinical and claims needs, please click here.