Add a Provider to an Existing Contract

  • Name of Provider to be Added * Required
  • Dell Children’s Health Plan is currently on CAQH and is able to pull credentialing information from the CAQH database. Please ensure that you authorize Seton Insurance Services PO ID #1097 to access their information.

    Please ensure that the following documents are loaded in CAQH and attested to within the past 6 months:

    • Texas Standardized Credentialing Application
    • Proof of Malpractice Insurance
    • Copies of all Licensure
    • DEA/DPS if applicable
  • If you are currently not enrolled with CAQH, please register here: https://proview.caqh.org/Login?Type=PM
  • Practice Location Full Address * Required
  • Credentialing Contact Name * Required
  • This field is for validation purposes and should be left unchanged.