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Provider

Assistance

The Partners Health Plan Network Development and Provider Relations team is here to assist you with your billing, claims, authorization, education, general inquiries, and with joining the PHP Provider Network. Please submit the form below to contact us for assistance.

If you would like to submit a Provider Ticket Submission Form using a mobile device or tablet, please CLICK HERE for our mobile-friendly form.


Provider Ticket Submission Form
First Name  
Last Name  
Email  
Phone  
Provider/Agency Name  
Provider Tax ID  
Agency / Provider Type   
Region   
Category   
Sub Category   
Subject  
Description of Assistance Need   
Priority   
Attachment   
Attach files
Each of your file(s) can be up to 20MB in size.
   
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