New Provider Orientation Training

Welcome to Peach State Health Plan! You are now considered a participating provider! Please complete our New Provider Orientation training. Once completed, please complete the form below for confirmation.

If you have any questions, please contact your Provider Representative at 1-866-874-0633.

2023 New Provider Orientation Presentation (PDF)

New Provider Orientation Training Confirmation

Provider Group *

Provider TIN(s) * Please provide any additional TINs that should be represented on this form.

TIN 2

TIN 3

TIN 4

TIN 5

Phone *

Email *

Form Completed By *

Title *

Date *

Training Confirmation * The 2022 New Provider Orientation training has been completed by the Provider Group above.