Downloads & Forms - Beth Israel Lahey Performance Network

Common Forms

Below are commonly used forms for your convenience.

Provider Forms

For any changes to the provider and/or your practice that you wish to notify the payer plans of, please complete the following PDF form and email it to:

WINHOSP_WinPHOEnrollmentTeam@lahey.org

Please note that we will submit this to the BIHLPN contracted payer plans only. Any other contracted/credentialed payer plans will need to be submitted through its respective contacts.

BILPHN _Change Form

Provider Newsletters

We’ve gathered links to the provider newsletters from our insurers for your convenience.

Common Forms

Provider Forms

Application & Forms

Referral Forms

EPIC Access Links and Forms

Provider Termination Notification

Provider Change Form

WinPHO Claim Intake Form

Provider Newsletters

Health Plan Provider Newsletters