WKCC New Provider Form

In order to ensure that your providers are added as qualified participants of the ACO and get access to all the services and tools provided by WKCC, please fill out this form. If you do not have ALL REQUIRED information, please wait until all information needed can be provided. This will help alleviate any payer data confusion. Please ensure ALL payer data is entered correctly, Incorrect information will be rejected resulting in longer payer billing processing time.