Document Library

New Offerings – Information and Opt-Ins – Click the Link Below:

  • New For 2023
    • Tower Extrusions
    • Envolve Vision
    • Provider Partners Health Plan
  • Networks Closed
    • Cigna Healthspring Star+Plus – All patients transitioning to Molina
    • Stone Mountain
    • Bright Medicare Advantage

New Member Applications


2022-2023 Tiopa Physician Application

2022-2023 Tiopa BH-Chiro Physician Application


2022-2023 Tiopa Non-Physician Application

2022-2023 Tiopa Non-Physician BH Application

All Providers

Extra Services Online Form

Before completing the extra service form you will need, your CP 575 Letter from the IRS and a Bank Letter or voided check, a Certificate of Formation from the Secretary of State, and a Driver’s License for the provider and all owners.