Provider
Become a Provider
Apply to be a part of the Viva Provider Network today!
Become a part of our Viva Provider Network
We appreciate your interest in becoming a Viva Health provider. To apply to our network, please complete our Provider Application below.
Apply Now
New Provider Application
Fill out this form to enroll as a new provider for Viva Health. Please see requirements for what is needed to fill out this application.
Application Requirements
Documents Required
You will be required to upload the following items:
- Certificate of Professional Liability Insurance (COI)
- Tax Document (147c or CP-575)
If you do not have BOTH documents readily available to submit, we cannot accept your application.
CAQH Profile
A CAQH Profile ID is required for all practitioners*. If you have a CAQH Profile, please make sure that you have given Viva Health viewing access and have updated your profile with your current practice location.
*Exception: Currently, we will accept an application from a Dental Provider without a CAQH Profile ID.
After Hours Call Coverage
After Hours Call Coverage is required for the following specialties:
Advanced Heart Failure and Transplant Cardiology, Cardiology, Cardiothoracic Surgery, Cardiovascular Disease, Cardiovascular Surgery, Colon Rectal Surgery, Concierge Medicine, Critical Care Medicine, Endocrinology, Family Practice/ Family Medicine, Female Pelvic Medicine And Reconstructive Surgery, Gastroenterology, General Practice, General Surgery, Geriatric Medicine, Gynecologic Oncology, Gynecology (Only), Hematology and Oncology, Internal Medicine, Interventional Cardiology, Medical Oncology, Neonatal-Perinatal Medicine, Neonatology, Neurological Surgery, Neurosurgery, OB/GYN, Oral Surgery, Orthopedics & Surgery, Palliative Medicine, Pediatric Cardiology, Pediatric Critical Care Medicine, Pediatric Endocrinology, Pediatric Gastroenterology, Pediatric Hematology, Pediatric Hematology and Oncology, Pediatric Medicine, Pediatric Oncology, Pediatric Orthopedics, Pediatric Pulmonology, Pediatric Surgery, Pediatric Urology, Perinatology, Plastic Surgery
Need Help or Have Questions?
For any questions and/or to request additional information, contact our Viva Health representative in your area.
Steve Edge
Please contact Steve Edge, Manager of Network Development.
Helpful Information
In order to participate in our network, providers must have an active provider contract.
Please contact VIVAparticipation@uabmc.edu or submit an application for participation and a representative will provide you with contracting details as necessary.
The Viva Health Provider Manual is full of valuable information for our participating providers. We update the manual annually. Participating Viva Health Providers are required to comply with the contents of the manual in accordance with the provider contract. Click here to access our Provider Manual.
If you would like more information regarding our Connect for Quality (C4Q) PCP incentive program, designed to enhance the quality of care and health outcomes for Viva Medicare members, please review the Viva Health Provider Manual.