Become a Participating Provider

Thank you for your interest in participating in one or more of our provider networks or health plans! Highly-qualified, independent providers are central to our ability to provide the best care to our members.

If you are interested in becoming a participating provider for the following networks or plans, please complete the Provider Interest Form.

  • Banner Health Network (BHN)
  • Banner Medicare Advantage, including Banner Health Plan, Inc. (BHP) and Banner Health Insurance Group, Inc. (BHIG)
  • Banner Network Southern Arizona, LLC (BNSA)
  • Banner University Family Care, Inc. (BUFC)
  • Banner University Care Advantage (BUCA)

Please attach a list to the Provider Interest Form of all providers and locations that you wish to be included in a contract. If you wish to contract only for AHCCCS plans and/or BUCA, you may attach AzAHP forms as an alternative to completing the detailed practitioner questions in this online form. If you wish to contract for any AHCCCS plans or BUCA in addition to other products, that information will be separately requested if it is not already included with your Provider Interest Form should a decision be made to offer a contract. Please note that completing the Provider Interest Form is not a guarantee that a contract will be offered.

Behavioral Health providers should attach a summary description of programs, including target populations and age categories, specific models of care/therapies used, along with frequency of programming treatment.

Instructions for Submitting Information with the Letter of Interest (For Behavioral Health Providers)

Please allow up to 120 days to receive a response to your BHN Provider Interest Form. For providers in specialties with a Clinical Governance Committee, additional information may be required before a contracting decision can be made.

If you have questions in completing the Provider Interest Form, please email .

Please note: At this time, none of our plans or networks are seeking additional providers in the following specialties:

Maricopa County Only

  • Ambulatory Surgery Centers (ASC)
  • Audiology
  • Cardiology
  • Hand Surgery
  • Hospice
  • Infertility
  • Oncology
  • Ophthalmology
  • Orthopedics
  • Pain Management
  • Physical Therapy
  • Podiatry
  • Radiology
  • Sleep Apnea
  • Spine Surgery 

Maricopa, Pinal, and Pima Counties

  • Acupuncture
  • Chiropractic
  • Durable Medical Equipment (DME)
  • Infusion
  • Labs
  • Occupational Therapy
  • Orthotics and Prosthetics
  • Physical Therapy
  • Urgent Care