Provider Participation Request

Please use the form on this page to submit your request.

Medical Associates Health Plans contracts with physicians and providers to provide services to our members who reside in Iowa, Illinois, and Wisconsin.  If you are interested in participating in our provider network, please fill out the form and a Medical Associates representative will contact you once the request has been reviewed. If you are a group practice and/or facility with multiple locations and/or providers, please complete the request and submit a roster with the additional information to cwilwert@airzona.net.  The review process could take up to 60 days depending on scheduling.  If you do not receive a response after 60 days, please send an e-mail to cwilwert@airzona.net to request an update on your request.