Add New Facility Form
Please complete this form to add a provider to your existing contract with Baylor Scott & White Health Plan (BSWHP).
Submission of this form is not an automatic approval to BSWHP’s network.
We will contact you for more information or confirmation of your request.
Please complete all fields. Enter N/A if a field is not applicable.
* Indicates required information
Problems!
Not all required elements have text entered or a value selected.Please enter values for all of the fields in the color of this box below.
Once done, click the "Submit" button again.
Success!
Thank you again for your request to add a provider to your Scott and White Health Plan contracted group.
Please allow 30-45 days before checking on status.
Problem
The form appears to have experienced difficulty during submission.
Please download, fill out, and email the SWHP Add Provider to Existing Contract Form to ensure timely handling of your request.
Thank you again for your request to add a provider to your Scott and White Health Plan contracted group.
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