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 for participating USA MCO Providers, include details for for administrative office staff.

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

Additional Provider Credentialing: Use this form to add one or more Providers to an existing agreement.

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.

Questionnaire.

Texas Workers’ Compensation Providers Click here.

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USA Managed Care Organization

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