Please complete this form if you would like to amend your current BSWHP contract, which includes adding BSWHP products to existing agreement, TIN or legal name change, contract rate negotiations, adding services to your existing contract, etc. Please complete all fields. Enter N/A if a field is not applicable to you.
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Please provide a detailed explanation in the comment section regarding the modifications you would like to make to your current BSWHP contract:
Thank you again for your request to add a provider to your Scott and White Health Plan contracted group. Please allow 30-45 days before checking on status.
The form appears to have experienced difficulty during submission. Please download, fill out, and email the SWHP Add Provider to Existing Contract Form to ensure timely handling of your request.
Thank you again for your request to add a provider to your Scott and White Health Plan contracted group or...