Interested in joining our network as a participating provider?

Thank you for your interest in joining Passport Health Plan’s network of participating providers.

Passport Health Plan (Passport) currently provides coverage to Medicaid and Medicare members. Contracted providers are an essential part of delivering quality care to our members. We value our partnerships and appreciate the family-like relationship that you share with our members.

To join Passport Advantage’s provider network, fill the form.


Adding a Provider to a Participating Group? Click here (Once this form is completed, please return, along with any other applicable information, via email.)

Thank you for your interest in joining Passport Advantage’s network of participating providers. As a provider-sponsored plan, we believe your participation is vital to our mission to improve the health and quality of life of our members.