Welcome to Managed Care Consultants, Inc.

This page should help explain the steps required to become a Managed Care Consultants, Inc. (MCC) contracted provider.
Please read and follow these instructions.

First Time Providers:
The first step is to fax a Letter of Intent to attention: Provider Relations Department. (702) 933-6659. Make sure all the information requested below is included in the letter.

  • Provider Name
  • Practice/Group Name
  • TIN #
  • Practice Address, Phone # and Fax #
  • Billing Address, Phone # and Fax #
  • Service you wish to perform
  • Proposed effective date

You can also get a "head start" on the application process by downloading the MCC Credentialing Application (please note this on the letter).

In order for credentialing to be processed quickly, it is imperative that the credentialing application be completed thoroughly.


Please attach a copy of the following:
  • Copy of Current Primary License
  • Copy of Current DEA (as applicable)
  • Copy of Current State Pharmacy Certificate
  • Copy of Current Malpractice Insurance Certificate
  • Signed and Dated Questionnaire
  • Explanations for all “Yes” answers on the Questionnaire
  • Copy of current Curriculum Vitae
  • Office Assessment Survey (for PCPs and OBGyns only) (copy of survey can be downloaded below)
  • W9 form with billing address (copy can be downloaded below)


Managed Care Consultants, Inc., Credentialing Department must receive all elements listed above prior to starting the credentialing process.

Please be advised that the credentialing process may take 60 to 120 days to complete once the minimum requirements have been received. Provider will be notified in writing when the process is completed.

The following PANEL(s) is/are currently closed if you practice in the Las Vegas/Clark County area:

Chiropractic (DC)

MCC Retains the right to close any panel based on network evaluation.

If you are a Northern Nevada provider, please contact Hometown Health at (775) 982-3232 for credentialing information.

These forms are in Adobe Acrobat format. If you don't have the free Adobe Acrobat Reader, Click here to download it.


Download Forms:

Initial Credentialing Application

MCC Re-Credentialing Application

W-9 Form

Instructions for W-9 Form

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