Contact Us (Payers)

Nominate a Provider

If you are interested in nominating a provider in our SuperMed PPO network, please use our Provider Nomination Form.

Payers and administrators interested in SuperMed Network should submit the form below.

Fields marked with an asterisk (*) are required.

Sender Information

*Subject:	-Select a subject from the list below- Sales & Marketing for the SuperMed PPO Network in Ohio Provider Search Question Claim Questions Other
*Name:	<--Name Required!
*Client:	<--Client Required!
*Phone:	() - - <--Phone Number Area Code Required! <--Phone Number Exchange Required! <--Phone Number Line Required! <--Invalid Phone Number Area Code! <--Invalid Phone Number Exchange! <--Invalid Phone Number Line!
*Email Address:	<--Valid Email Required! <--Valid Email Required!
*Questions/Comments:	Comments Required!