Renew with HNA

 

Doctor's First Name:

 

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Malpractice Insurance Carrier

 

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State License

 

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DEA Certificate (Does not apply to D.C.)

 

Specialty: Specialty... A - Allergy only ACU - Acupuncture ADD - Addictive Medicine AI - Allergy and Immunology AN - Anesthesiology ASC - Ambulatory Surgery Center AT - Athletic Trainer AUD - Audiology & Audiologist AUDCTR - Audiology Center* BMT - Bone Marrow Transplant BRS - Breast Disease/Surgery CCM - Critical Care Medicine CD - Cardiovascular Diseases CDEL - Cardiac Electrophysiology CHIRO - Chiropractic CISW - Clinical Social Worker CMD - Chemical Dependancy CPTH - Cytopathologist CRS - Colon and Rectal Surgeon CVS - Cardiovascular Surgeon CVTS - Cardiovas/Thoracic Surgeon D - Dermatology DENT - Dentistry DME - Durable Medical Equipment DPTH - Dermapathology DR - Diagnostic Radiology DRC - Diagnostic Imaging Center ELP - Electrophysiology EM - Emergency Medicine END - Endocrinology ENDO - Endoscopy FP - Family Practice G - Genetics GE - Gastroenterology GER - Geriatrics GP - General Practice GS - General Surgery GYN - Gynecology GYNON - Gynocology and Oncology HEM - Hematology only HEMON - Hemotology and Oncology HH - Home Health HIS - Hearing Instrument Specialist HNS - Head and Neck Surgery HOL - Holistic Medicine HS - Hand Surgery HSP - Hospitalist HYPER - Hyperbaric ID - Infections Diseases IM - Internal Medicine INDM - Industrial Medicine INFER - Infertility LAB - Laboratory MCT - Mechanotherapy MDH - Integrative Medicine MENTA - Mental Health Specialties MFM - Maternal Fetal Medicine MFS - Maxilloficial Suregon MFT - Marriage Family Therapist MT - Massage Therapist N - Neurology NAT - Naturopathic & Naturopath DR NEP - Nephrology NM - Nuclear Medicine NMW - Nurse Midwife NOPH - Neuro-Ophthalmology NP - Nurse Practitioner NPM - Neonatology NPSY - Neuropsychology NS - Neurological Surgeon NTR - Nutrition OB - Obstetrics OBG - Obstetrics and Gynecology OCT - Occupational Therapist OCU - Ocuplastic/Reconstructive Eye Surgeon OM - Occupational Medicine ONC - Oncology ONS - Oncology Surgeon OPH - Ophthalmology OPTO - Optometry & Optomotrist ORS - Orthopedics OS - Oral Surgery OSS - Ortho-Spine Surgeon OT - Otology OTO - Otolaryngology P - Psychiatry PA - Physician's Assistant PD - Pediatrics PDA - Pediatric Allergy PDAI - Pediatric Allergy and Immunalogy PDCCM - Pediatric Critical Care Medicine PDCD - Pediatric Cardiology PDCVS - Pediatric Cardiovascular Surgeon PDCVT - Pediatric Cardiovascular and Thoracic Surgery PDEND - Pediatric Endocrinology PDGE - Pediatric Gastroenterology PDHEM - Pediatric Hemotology+Oncology PDID - Pediatric Infectious Disease PDN - Pediatric Neurology PDNEP - Pediatric Nephrology PDONC - Pediatric Oncology PDOPH - Pediatric Opthalmology PDORS - Pediatric Orthopedics PDOTO - Pediatric Otolaryngology PDP - Pediatric Psychiatry PDPSY - Pediatric Psychology PDPUD - Pediatric Pulmonary PDS - Pediatric Surgeon PDU - Pediatric Urology PHL - Phlebology PLB - Phlebotomy PM - Preventive Medicine PMR - Physical Medicine & Rehabilitation PNC - Pain Management POD - Podiatry PS - Plastic Surgery PSR - Plastic And Reconstructive Surgery PSY - Psychologist PT - Physical Therapy PTH - Pathology PTHLAB - Pathology Lab Facility PTHLB - Pathology Lab Facility PUD - Pulmonary PYA - Psychoanalysis R - Radiology REND - Reproductive Endocrinology RHI - Rhinology RHU - Rheumatology RN - Registered Nurse RONC - Radiology and Oncology RTVT - Retina & Vitreous/Eye SCL- Sclerotherapy SLP - Sleep Disorder SLPC - Sleep Center SM - Sports Medicine SPTH - Speech Pathologist SW - Social Worker (licensed) TPS - Transplant Surgeon TS - Thoracic Surgeon U - Urology UC - Urgent Care UCC - Urgent Care Center VS - Vascular Surgeon WC - Wound Care

 

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By checking this box and entering my initials, I represent that I have read and understand the Terms and Conditions of my membership. I further represent that all of the information submitted on the above enrollment form is correct to the best of my knowledge.

 

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To Renew your Credentialing Offline

Follow these steps:

Step 1: 

Complete the one page downloadable Renewal Form, and submit with membership fees.  You may FAX it to 602-485-3100 or mail in the forms.  If you are a facility, download the Facility Renewal Form.

Step 2:

A confirmation will be sent to you upon completion.

Valued HNA Member:

Our goal is to bring you programs to make your practice a more profitable practice - to get more patients, lower overhead and better practice efficiency.

• HNA has added additional patient contracts bringing the total to 6,800 payers
• HNA providers currently service over 24 million patients.
• HNA instituted a vendor program to offer discounts on practice expenses
• HNA created an information and education email system to inform you on critical practice issues
• HNA has NO automated phone system.  You Call - We Answer!  Making out systems more provider friendly.
• Save time and save a stamp by renewing your membership electronically.

Download the one page Renewal Form, complete the form and FAX it back to 602-485-3100 or mail in the renwal to 3420 E Shea Blvd Suite 130, Phoenix, AZ  85028