Provider Application
StartYourTPNApplication
Tell us about your practice and capacity. Our provider network team reviews every submission and follows up about market availability and next steps.
A short first step, not a full credentialing packet
This is a brief interest form. There is no application fee, no account to create, and no file uploads at this stage. If your practice looks like a fit, the Empower Trusted Partner Network team will guide you through credentialing and next steps.
What happens after you apply
The provider network team reviews your submission
Your practice details, specialties, locations, and capacity are reviewed against current network needs and market availability.
We follow up about fit and next steps
If your practice looks like a fit, the team reaches out to discuss your market, answer questions, and begin credentialing.
You review written participation terms
Participation terms are provided in writing before you accept treatment responsibility. You decide whether to proceed.
Submitting this form creates no obligation for your practice. Nothing is binding until you review and sign written participation terms.
- No application fee
- No obligation to accept every referral
- Referral volume is not guaranteed
- Participation is subject to credentialing and market availability
- Clinical judgment remains with the treating provider
- Financial terms are established in the provider agreement
- You receive the applicable terms before accepting treatment responsibility