Forms and Documents for Existing USA MCO Providers

Below you will find Provider forms and information for Providers participating in a USA MCO Network. If you do not see specific form or document you are looking for, contact our Provider Relations team at (800)USA-0820.

Quick Reference Guide provides helpful information participating USAMCO Providers, include details for for administrative office staff.

Patient Referral Form: If a provider you frequently refer patients to is out of network, simply complete, save and email or print and fax us this form and our Network Development team will contact them.

Provider Information Change Notification Form: To notify USA MCO of a change in name, new contact information, or new EIN# / SSN.

Provider Satisfaction Survey: Take a moment to let us know how we are doing.

Patient Satisfaction Survey Results: See the results of our Patient Satisfaction Survey.

Practitioner Site Survey Results: View the results of our Practitioner Site Survey Questionnaire.

Texas Workers’ Compensation Providers Click here.


USA Managed Care Organization

Get more information on becoming a provider in USA MCO’s Networks