Provider nomination form

Let us make the introduction!

Your medical plan is open-access, which means you have the freedom to choose any health care provider you wish, without restrictions or limitations from your plan or network. In some cases, your provider may be unfamiliar with your new plan. Let us remove the unnecessary stress and make the initial introduction for you!

As part of ClaimDOC’s Pave the Way program, a Member Advocate will contact your provider and introduce your new plan before your first appointment, ensuring that your provider has the information they need to treat you and submit your claims.

Submitting your healthcare provider’s information is easy—simply complete the form below. Or, if a phone call is easier for you, you may submit your request by calling 888.330.7295. We’ll notify you when a ClaimDOC Member Advocate has begun your case and keep you updated along the way. We are ready to partner with you!