You are welcome to fax or email any updates that need to be made to your provider profile. Changes may include staff, name, address, phone, fax or credentials. Be sure to include a fax cover sheet along with your name and telephone number in case we have any questions.
To protect the privacy of the client as well as yourself, please do not email any form with personal health information included (PHI) unless it is encrypted and password protected according to HIPAA compliance standards.
For all credentialing information:
Mail to MYgroup, Attn: Provider Management, 5925 Carnegie Blvd., Suite 350, Charlotte, NC 28209. Or, fax to 704-529-5917. Attn: Provider Management
For questions about provider management:
Call 866-850-2175 x2, x4. Or, email [email protected]