Payer and Credentialing Forms

Next Steps

To get started on your health system's inclusion in IHOC's specialty network and to comply with payer requirements, IHOC requires the below questionnaires and forms be completed. Thank you in advance for taking the time to provide us with this critical information. 

Payer Analysis

Please submit completed forms to

IHOC Specialty Network

Payer Questionnaire

To develop your payer strategy, please fill out this form and return it to Once we receive your returned questionnaire, we will provide you with a report on payer and employer targets for your specialty pharmacy and will start on the strategy development for the pursuit and execution of payer contracts. 

Credentialing Forms

Please ensure that required fields are completed prior to submitting

Submit forms

IHOC Specialty Network

Credentialing Contact List

IHOC Specialty Network

Pre-Qualification Questionnaire

IHOC Specialty Network

Business Information Form