Credentialing
Credentialing is required for certain provider types at participating facilities. Below, we have information and resources to help you with the process. If you need additional assistance, contact the Provider Contact Center and we will be happy to assist you.
PrimeWest Health and the Minnesota Credentialing Collaborative (MCC)
PrimeWest Health has joined the Minnesota Credentialing Collaborative (MCC) to offer our providers a streamlined option for submitting their credentialing applications to PrimeWest Health. By joining MCC, providers can access and use a centralized, web-based clearinghouse for information used in the credentialing process. The online product is an easy way to prepare, save, and send the credentialing application that is accepted by participating Minnesota health plans, hospitals, clinics, and practitioners. Visit the MCC website to learn more. Read more about the MCC.
Credentialing Forms
Use the forms below if you are a contracted provider with PrimeWest Health and you need to enroll a new practitioner.
- MN Uniform Credentialing Application
Use to enroll a new practitioner -
Minnesota Uniform Recredentialing Application
Use to re-enroll a practitioner - Fitness Professional Credentialing Application Form
Use to enroll a new fitness professional - Minnesota Uniform Practitioner Change Form
Use to add, remove, or make a change to demographic data for credentialed practitioners or add specialists not subject to credentialing - Personal Care Assistant (PCA) Application
Use to enroll a new Personal Care Assistant - Pharmacist Enrollment Application Use to enroll a new pharmacist at a Medication Therapy Management (MTM) services pharmacy
- Practitioner Information Request Form
Use to enroll a specialist not subject to credentialing
Credentialing References