Independence Provider Hub  

Forms for providers

Our most commonly used forms are available below:

Additional resources

The peer-to-peer process streamlines workflows, improves cost-efficiencies, and complies with accreditation requirements. To participate in the peer-to-peer process, please complete the Peer-to-peer Request Form.

If you are interested in having a registered nurse Health Coach work with your Independence patients, please complete a Physician Referral Form or contact us by calling 1-800-313-8628.

Providers must complete a request form for all prescription drugs that require prior authorization. More information about this process is available on the prior authorization page.

Order paper copies of manuals, newsletters, directories, health and wellness materials, and more. Please note that claim forms, such as the CMS-1500, are not available through the Provider Supply Line. They are available for purchase at many local office supply stores.

Use this form to request a copy of your provider contract or a provider rate/fee schedule for a specific specialty.

To receive the latest news and information of interest to the Independence provider community by email, participating providers can complete this form.

Forms are not used to verify member eligibility or to check the status of a claim. Instead, please use PEAR Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal or call 1-800-ASK-BLUE (1-800-275-2583) to access the Provider Automated System.