Forms, Downloads & Links

Brokers

Forms & Downloads

• Authorization for Use and Disclosure of Protected Health Information

  Specify who can receive your health information and exactly what information that they can receive with this simple form.

Helpful Links

• Companion Life Forms

  We carry a variety of ancillary products through Companion Life. Here you'll find the employer group application and employee enrollment forms.

• FSA/HRA Forms

  Find all the forms you need in one place regarding FSA and HRA information. Find dependent care claim forms, pricing sheets, and other helpful resources.

• General Forms

  Gain access to various forms you'll use such as group renewal confirmation forms, medical change forms, prior carrier credit forms, and more.

• Member Enrollment Packet

  These member enrollment forms will provide quick and easy onboarding for your new clients. Equip them with knowledge of PHP, how to use the online provider directory, understand where forms are located, and more.

• Sample Plan Options

  Browse sample plans and sample certificates of coverage for a variety of our different health insurance plan categories, including:  HMOs, Point of Service, and High Deductible plans.

Media/Press

Forms & Downloads

• PHP Brand Guidelines

  Learn in more detail about PHP's primary and secondary colors, logo formats, and other branding guidelines.

• PHP Logo - Digital

  Here you will find PHP's official logo in horizontal format for your online use.

• PHP Logo - Print

  Here you will find PHP's official logo in horizontal format at print quality resolution.

Helpful Links

There are currently no Helpful Links available.

Members

Forms & Downloads

• Authorization for Use and Disclosure of Protected Health Information

  Specify who can receive your health information and exactly what information that they can receive with this simple form.

• Medical Treatment Consent Form

  Leaving your child with a babysitter or family member may mean they won't recieve care without your consent. This will ensure that in an emergency, your child will receive prompt, necessary medical care even if you are not there.

Helpful Links

• Centers for Medicare & Medicaid Services

  These links will direct you to government-based Web sites that include detailed information on HIPAA and related healthcare issues.

• Medical Dictionary

  Medical jargon can be difficult to understand if you're not around it all the time. This medical dictionary can help you understand frequently used terms, different kinds of tests, and more.

• Symptom Checker

  Know your symptoms? Check out what they might mean with this helpful tool. As always, be sure to consult your family doctor if symptoms get worse.

• United States Department of Health & Human Services

  These links will direct you to government-based Web sites that include detailed information on HIPAA and related healthcare issues.

Providers

Forms & Downloads

• Credentialing Criteria

  Find out more about how to become an in-network provider with PHP, including information about what to expect during our credentialing process, recredentialing, and more.

• Healthcare Facility Credentialing Form

  Complete this form to begin the credentialing process as a healthcare facility.

• Provider Credentialing Form

  Complete this form to begin the credentialing process as an individual healthcare provider.

Helpful Links

• CareCore Forms

  Find all the CareCore forms you need in one place. Quick, easy to find, and downloadable!

• General Forms

  Gain access to the InstaMed Network Funding Agreement and Adjustment Request form by logging into your provider account.

• Medical Management Forms

  Here's a quick link to the Prior Authorization Request form as well as out-of-network referral paperwork and more.

• Pharmacy Forms

  Various forms and information on growth disorders, prescription programs, and more can be found here.