To Apply

To join our network, simply call us at (888) 510-CARE and request an application. You will be asked to pay a one-time application processing fee of $25 and we will send all documents necessary to start the credentialing process. Or you may send $25 to AcuCare, 2500 E. Foothill Blvd., Suite 401A, Pasadena, California 91107 and we will forward an application package to you directly. Upon acceptance, your name will be included in our highly respected network and you can begin enjoying benefits immediately.

Or, If you prefer, download the documents off of our website, and pay the reduced rate of only $15. The following check list outlines the items we need from you to begin the credentialing process.

To submit all requirements for a Complete Application, follow the instructions in Steps 1-4 below.

Step 1. Acu-Care forms can be downloaded by clicking on the underlined links below.

The four documents below ARE MANDATORY for the credentialing process and must be completed and signed and returned to AcuCare in order to be considered for credentialing:

• Application for AcuCare Acupuncture Network
    
• Authorization and Release form
    
• AcuCare HealthCare Provider Agreement
    
• W9

The following documents are Payor Summaries. You may choose to participate in one or all of the following networks offered. Read each summary carefully and sign and return an agreement for each program in which you wish to participate.

• Beech Street
    
• Cigna PPO (not offered in New Mexico)
    
• Cigna HMO (not offered in New Mexico)
      
• ClarisPointe
    
• CorVel (not offered in New Mexico)
    
• Interplan Health Group
      
• FOCUS Healthcare Management (formerly MetraComp) (not offered in New Mexico)
      
• MultiPlan (Names and Logos of MultiPlan and its subsidiaries)

Step 2. Document copies you need to provide.

Send a copy of the following documents to AcuCare:

• the declaration page of your Malpractice (Professional Liability) Insurance Policy. Limits must be 1M/3M.
    
• the declaration page of your General Liability Insurance Policy. Limits must be at least 1M/2M and must reflect the address(es) from which you are practicing.
    
• a current Curriculum Vitae/Resume, with dates covering the last five (5) years. You must explain any gaps in time greater than 6 months. Activities must be documented with a month and year start date and a month and year end date. (eg.: Jan 1999-June 2001/ Attended University; September 2001- May 2002/ Interned etc.)

Step 3. Fees you need to pay.

When submitting your completed resume, please send the following fees:

• $300 Annual Membership Fee (Your renewal date will be one year from the Acu-Care acceptance date. If you are not accepted, your fee will be returned).
      
• $60 Site Inspection Fee. A one-time fee payable for each location where you practice, from which you will submit claims and those you want listed in our network and your selected payor networks. More information for site inspection requirements...
    
• If you have not already paid the Application Processing Fee the following will apply.
    
• $15 for download version
    
• $25 to receive a package through the mail.

Step 4. Send the completed package as indicated above to:

Acu-Care
2500 E Foothill Blvd., Suite 401A
Pasadena, CA 91107-3464