If there is a doctor who you would like to see join our network you may nominate them using the Provider Nomination Form below. Once we receive the nomination form, we will contact the provider to see if they are interested in joining our network.

Please keep in mind that all nominated providers must submit an application and complete the credentialing process. This application and credentialing process may take up to 6 months to complete. Until this process is complete you may need to see a different doctor who is already in the network or obtain an out of network authorization. Generally, if a provider has completed the application we will provide Out of Network authorizations until the network credentialing process is completed. Also, not all providers complete the application process. There is always a chance that a provider who has been nominated will not join our network.

You can mail the nomination form to:
US Family Health Plan
Attention: Network Operations
450 West 33rd St, 12th Floor
New York, NY 10001

Or fax it to: 212-356-4849

You may also email the form to: usfamily@svcmcny.org