Recommend a Provider

Tell us about the provider you are recommending:

"*" indicates required fields

First Name

Last Name

Provider Organization*

Provider Type

Address Line 1

Address Line 2

City

State

ZIP Code

Contact person at provider

First Name

Last Name

Phone

Tell us about yourself

Optional

First Name

Last Name

Address Line 1

Address Line 2

City

State

ZIP Code

The employer who offers you health coverage using The Alliance network

Are you currently seeing the provider you're recommending?

Yes

Recommend a Provider

If you learn that your health care provider is not part of The Alliance^® networks you can recommend them to be contacted by The Alliance. Unfortunately, this does not guarantee that a provider will become a part of our network. The Alliance determines provider network growth based on: employer needs and network adequacy for our enrollees. Any services provided will be billed at out-of-network rates until an agreement is reached between The Alliance and the recommended provider.

Fill out the form below to recommend a provider or you can call The Alliance at 800.223.4139. External Link. Opens in new window. and ask to speak to Customer Service.

Our Customer Service Team

800.223.4139. External Link. Opens in new window.

Hours:
Monday-Thursday: 7:30am-4:30pm CST
Friday: 7:30am-11:30am CST

Our Addresses

Mailing Address:
PO Box 44365
Madison, WI 53744

The Alliance Office:
5510 Nobel Dr.
Suite 200
Fitchburg, WI 53711