Join Our Network

Apply to Join Our Network

We use CAQH for credentialing.

If you already have a CAQH ProView profile, getting started is easy. Enter basic provider information and upload the required documents. We will use your CAQH information during the credentialing review.

Team of diverse clinical reviewers discussing a provider panel

Network Participation Request

Complete this form to request participation in the our network. We will use the information you provide to begin the credentialing and contracting process.

Retail chains: Contact your corporate office to request participation.

Groups: Submit one request for each tax identification number (TIN). Enter the name of one practitioner from the group on the form.

Before You Apply

Make sure:

  • Your CAQH profile is current and attested.
  • All required credentialing documents have been uploaded to CAQH.
  • Centene (Envolve) has access to your CAQH profile.

You will also need to submit a completed Provider Address Form and any required supporting documents for contracting and network setup.

Use the form below to begin the credentialing and contracting process.

Do you have a CAQH ID? required *

Create a CAQH Profile

Centene Vision uses CAQH for credentialing. If you do not have a CAQH ID, create a CAQH profile before submitting this request.

Create a CAQH Profile

Once your profile is complete and attested, return to this form and enter your CAQH ID to continue.

Select the state where the provider practices.

Required Documents

Download, complete, and upload the required documents.

For groups with more than five providers or multiple locations: Use the Large Group Roster (XLSB) instead of the Provider Address Form.

Notice to Texas Physicians and Eye Care Providers

As a licensed eye care HMO, we seek to contract with any willing provider. We impose the same application requirements on all providers. We accept on a continuous basis applications from ophthalmologists, optometrists, therapeutic optometrists, and opticians to join our Medicaid, Medicare, Commercial and Health Insurance Marketplace networks of eye care providers. Applications can be obtained by request providercontracts@envolvehealth.com or by calling 1-800-531-2818.

Required Documents

Download, complete, and upload the required documents. 

For groups with more than five providers or multiple locations: Use the Large Group Roster (XLSB) instead of the Provider Address Form.

Note: A DEA/CDS waiver is required for ophthalmologists only. It is not required for optometrists.

Provider Information

Provide information for the provider requesting participation.

If this request is for a group, submit one form per group or TIN and use the name of any practitioner within the group.

Provider's CAQH ID
TIN associated with the provider's practice or organization

Submitter Contact Information

Provide contact information for the person completing this request.

We'll use this email if we need additional information during the credentialing and contracting process.
Preferred Contact Method
Use this field to provide information that may affect the provider's participation request.

Upload Documents

Provider Information

Provide information for the provider requesting participation.

Provider's CAQH ID
Tax ID associated with the provider's practice or organization

Submitter Contact Information

Provide contact information for the person completing this request.

Preferred Contact Method