For resources on managing current events, log in to the portal using your company code.

Existing Affiliate Provider Updates

If you are an existing Affiliate Provider with Workplace Solutions and any of your credentialing information has changed, or you would like to sign up for direct deposit, please use the following links to send us your updated documents. Please upload only active licenses and certifications, and proof of malpractice insurance with dates and coverage amounts.
Name(Required)
Email(Required)
Drop files here or
Accepted file types: pdf, doc, docx, jpg, png, gif, xls, xlsx, txt, Max. file size: 10 MB, Max. files: 10.
    All uploaded licenses and certifications must be active and in good withstanding.
    Accepted file types: pdf, jpg, gif, png, txt, doc, docx, Max. file size: 10 MB.
    Accepted file types: pdf, jpg, gif, png, txt, doc, docx, Max. file size: 10 MB.
    Accepted file types: pdf, jpg, gif, png, txt, doc, docx, Max. file size: 10 MB.
    Accepted file types: pdf, jpg, gif, png, txt, doc, docx, Max. file size: 10 MB.
    If the mailing address you use for taxes or any other tax information has changed, please complete and return a new W9 form now.

    Additional Information

    If you have any questions or concerns, you may call the Intake Department at 800-327-5071 during the typical daytime hours of 8:30 AM – 5:00 PM CST Monday through Friday.

    By clicking “Submit” you acknowledge and agree that you have already entered into a Business Associate Agreement (“BAA”) with Workplace Solutions. This Submission is a permitted disclosure as set forth in Section 2 of the BAA because you are using and/or disclosing any applicable PHI merely to comply with proper management and administration, and all information submitted will be held confidentially and used only as required by law or for purpose for which it was disclosed.