Provider Forms

Note: PDF forms require Adobe Acrobat Reader.

Coding - Fax Forms to 763-847-4957

Coding Appeal Form

Effective September 1, 2013 PreferredOne requires initial credentialing applications to be submitted using the MCC electronic Application as announced in the June 2013 Provider Newsletter.

Credentialing - Fax Forms to 763-847-4814 Attn: Credentialing

Medical Management - Fax Forms to 763-847-4014

Provider Relations - Fax Forms to 763-847-4010 Attn: Provider Relations