GOBHI Provider Network
Thank you for your interest in becoming an in-network provider for GOBHI. GOBHI evaluates our network needs on a regular basis for adequacy and for specialty services currently not provided by our provider panel. If you would like to be considered for an in-network application should the need for your services arise, please fill out the GOBHI Provider Interest Form and return it by sending it via secure email to firstname.lastname@example.org.
- The ADA compliance form and attestation will be due once a year unless changes occur. The first one is due February 7th, 2020. ADA form please submit to email@example.com
- The Practitioner list will be due on a monthly basis. Due by the 7th of the following month. The first one for 2020 due February 7th, 2020. If no changes are made please still submit with a note that there are no changes, i.e. terminations, new hires. Please submit the form to firstname.lastname@example.org
- Access Reporting is also due by the 7th for the following month. First one due on February 7th, 2020. Please submit the form to email@example.com