Use this online form to:

  • Verify whether HWMG’s provider directory correctly reflects your practice information (name, gender, specialty, office location addresses, email, phone numbers, accepting new patients, etc.).
    1. In the HWMG provider directory, type your first and last name or practice name in the search fields .
    2. Click the Search button and review your practice information.
    3. Submit the verification form below to confirm our provider directory correctly reflects your information. If any information is inaccurate, please upload a Provider Add, Delete or Change Form.
  • Inform HWMG of changes to your billing and mailing information including addresses (especially suite numbers), phone numbers, email addresses, and removal of providers no longer practicing due to retirement or other reasons. If a change is needed, please upload a Provider Add, Delete or Change Form.

Incorrect information on file may affect members’ access to care and delay your receipt of information from us. Thank you for your cooperation.

For assistance, contact our Provider Relations Department.

Verify or Update Provider Information

Providers may use this form to verify their information or submit a change request.

If you are not an authorized representative for the practice, please obtain authorization.

For assistance, contact our  Provider Relations Department.

This field is for validation purposes and should be left unchanged.
Provider Name*
Your Name*
A confirmation email will be sent to this address.
Are changes needed to the information in HWMG’s Provider Directory?*
Are changes needed to the provider’s Billing and Mailing Information?*
Provider Add, Delete or Change Form and/or other documentation, if applicable.
Drop files here or
Accepted file types: pdf, Max. file size: 2 MB, Max. files: 2.