Provider Forms

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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 763-847-4010 Attn: Credentialing

Coding - Fax Forms to 763-847-4957

Medical Management - Fax Forms to 763-847-4014

Provider Relations - Fax Forms to 763-647-2437