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SKILLED PROVIDERS. Evergreen Health Plan includes a network of hundreds of skilled local physicians and clinicians in a wide variety of disciplines. Plus, we've combined this network with affiliations at the region's most respected hospitals to create a network that is second to none.
 
Credentialing/ Recredentialing Requirements Form in (pdf) format
Request a copy of the current formulary Formulary in (pdf) format
Request for Taxpayer Identification Number and Certification (pdf) Form in (pdf) format
Fax Recall Instructions Form in (pdf) format
EMG PET Scan Criteria Form in (pdf) format
Continuation of Care Form Form in (pdf) format
Get the Adobe Acrobat Reader to view the above forms (pdf)