Thank you for your interest in participating with Managed Health Services (MHS). We are excited that you have selected MHS’ provider network as your network of choice.

Please use this form to apply or add additional providers: 

• Provider – New or Add Form (PDF)

Please note that all requests for participation will be reviewed by the MHS Network Development Group.  Several factors are used when making a decision.  These factors may include but are not limited to:

• Number of MHS members in your area
• Number of currently contracted MHS providers in your specialty in your geographic area
• Driving distance between members contracted MHS providers
• MHS business needs

All applicants will be notified in writing by the Contracting Department as to the decision of the committee within approximately 45 business days of receipt of your request.