PRIMEPROVIDER LIFE CYCLE MANAGEMENT
Auto-saving
MC

Welcome, Dr. Chen

You have been invited to join the Aetna provider network. We are excited to have you as part of our healthcare community. To complete your enrollment, please upload the required credentials below. Our system will verify each document in real-time.

michael.chen@example.com
Internal Medicine
NPI: 1234567890
AI-Powered: Our system will automatically extract information from your documents and pre-fill the enrollment form for your review.

Required Documents

Curriculum Vitae (CV)

REQUIRED

Your professional resume with work history

State Medical License

REQUIRED

Current valid medical license

DEA Certificate

REQUIRED

Drug Enforcement Administration certificate

Board Certification

REQUIRED

Specialty board certification document

Malpractice Insurance

REQUIRED

Current malpractice insurance certificate

W-9 Form

REQUIRED

Tax identification form

0 of 6 documents verified

Upload all required documents to continue

Additional Documents

Upload any supporting documents that may help expedite your enrollment, such as:

  • Additional state licenses
  • Hospital privilege letters
  • Reference letters
  • Continuing education certificates
  • Professional liability history

Need Help?

If you have questions about the enrollment process or document requirements, our support team is here to assist.