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🏥 Provider Onboarding

Set up your practice. We handle the rest.

Complete this form to begin onboarding. Your dedicated VCS coordinator will reach out within 24 hours to schedule your kick-off call and finalize the setup.

Practice Information

Practice Name *

NPI Number Group NPI preferred (10 digits).

Specialty (select all that apply) *

Orthopedics Pain Management / Spine Cardiology Infusion / Oncology Neurology Behavioral Health Multi-Specialty Other

Number of Providers

Monthly PA Volume

Primary Contact

Contact Name *

Title / Role

Work Email *

Phone Number

Practice Address

Street Address

City

State

ZIP Code

EHR & Technology

EHR System

Payer Mix

Primary Payers (select all that apply)

Aetna BCBS Cigna Humana UHC Medicare Medicaid Other

Current Auth Workflow

How do you currently handle prior authorizations? This helps us build a custom onboarding plan. No PHI — process description only.

Preferred Onboarding Start Date

HIPAA Business Associate Agreement

I acknowledge that VCS will operate under a HIPAA Business Associate Agreement (BAA). By checking this box, I confirm I am authorized to enter this agreement on behalf of my practice, and that VCS will handle protected health information only as necessary to provide authorization management services.

🔒 HIPAA Notice: Do not include patient names, member IDs, or PHI in this form. Practice and operational details only. A formal BAA will be executed prior to any PHI access.

Your coordinator will reach out within 24 hours. No PHI transmitted. Privacy Policy.

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Onboarding request received.

Your dedicated coordinator will reach out within 24 hours.

VCS-INTAKE-...

VCS-PRAC-...

Save your Practice VCS ID — you'll use it to reference your account with our team.

Submit a PA Now Access Portal

Onboarding timeline

1

Today — Submit this form

2

Within 24 hrs — Coordinator outreach + kick-off call scheduled

3

Day 2–3 — BAA executed, VCS portal access configured

4

Day 3–5 — First cases intake + workflow handoff

5

Week 2+ — Full operations + SMART scoring active

What's included

✓ Dedicated onboarding coordinator

✓ HIPAA BAA execution

✓ Secure portal access

✓ Payer-specific playbook library

✓ SMART Model™ scoring from day 1

✓ Real-time authorization tracking

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