Document Library

New Member Applications


Doctors

TIOPA Doctor Initial Application_2020

Physician Assistant Application

TIOPA AHP-PA Initial Application_2020

Nurse Practitioner Application

TIOPA AHP-NP Initial Application_2020

Other Mid-Levels

TIOPA AHP Initial Application-Midlevel_2020

TIOPA Plan Participation Checklist- Part of Application

Plan Participation Checklist- complete TIOPA-TXCIN 7-2019

Provider Relations Packet including Hospital Letters

TIOPA-Provider-Relations-Packet_Plan-Documents-Rev_2020

EXTRA SERVICES 

Extra Services Interest Form/Link

https://docs.google.com/forms/d/e/1FAIpQLSfRBDekeensINbzuhnWst2d5li4IaAsZQHChMBwV9a5awZZ5A/viewform

Extra Services Information (needed from Provider to get BCBS, Medicare, or Medicaid numbers)

http://bit.ly/ExtraServiceFormTIOPA