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Click ‘Get Form’ to open the Download Physician Application in our editor.
Begin by filling out the General Information section. Enter your last name, first name, degree, and specialty. Ensure all fields are completed accurately.
Proceed to the Undergraduate Education section. List your college or university details, including degree obtained and dates attended.
In the Medical Education section, provide information about your medical school, including the degree obtained and program completion status.
Complete the Post Graduate Medical Education section by detailing any internships, residencies, or fellowships you have completed.
Fill in the Board Certification section by indicating your current certification status and providing relevant dates.
Continue through each section of the form, ensuring that you mark N/A for any questions that do not apply to you.
Once all sections are filled out, review your application for accuracy before signing and dating it at the end of the document.

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Do I have a grace period on my health insurance?

Please include a complete discussion of your questions or situation and your reasons for dissatisfaction and submit the Appeal or Grievance to WHA Member Relations Unit, Appeals and Grievances Department within one hundred eighty (180) days of the incident or action that caused your dissatisfaction.

Who is the CEO of Western Health Advantage?

The 30-day grace period begins from the date of the notice of grace period. You need to pay past due premium within this 30-day grace period to avoid cancellation of coverage for nonpayment of premiums. Coverage will continue during the grace period.

What is the grace period for Western Health Advantage?

MyWHA by Western Health Advantage Quickly access WHA information digitally, order/print new cards and more with this app. Keep vital information with you and access your Western Health Advantage plan info from your smartphone. Its a handy reference, too, for contacting: WHA Member Services Department.

How do I choose a doctor on Western Health Advantage?

If you want to choose a different for yourself or your dependents, you can do so online through your MyWHA account or by calling the Member Services Department at 888.563. 2250. Well issue you a new ID card confirming your new s name. The effective date is the first day of the month following notification.

What is the grace period for medicare advantage plans?

Grace period of 30 days to renew your policy once it expires.

Download Physician Application - Western Healthcare 2025

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How to use or fill out Download Physician Application - Western Healthcare with our platform

Complete this form in 5 minutes or less

Got questions?

Do I have a grace period on my health insurance?

Who is the CEO of Western Health Advantage?

What is the grace period for Western Health Advantage?

How do I choose a doctor on Western Health Advantage?

What is the grace period for medicare advantage plans?

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Download Physician Application - Western Healthcare 2025

Here's how it works

How to use or fill out Download Physician Application - Western Healthcare with our platform

Complete this form in 5 minutes or less

Got questions?

Do I have a grace period on my health insurance?

Who is the CEO of Western Health Advantage?

What is the grace period for Western Health Advantage?

How do I choose a doctor on Western Health Advantage?

What is the grace period for medicare advantage plans?

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