Thank you for your interest in BILHPN – Beverly LCU. The first step in joining our network of physicians is to request LCPN membership. To ensure a smooth enrollment process and to minimize potential delays with insurance credentialing, the PHO recommends that you request NECoMG membership at the same time that Beverly Hospital privileges are being requested.
If a provider does not already hold Beverly Hospital privileges and has not already requested a privileging application, please reach out to Beverly Hospital Medical Staff Office (MSO) to request an application.
Amy McIntire
Manager, Medical Staff Office
amy.mcintire@lahey.org
Phone: 978-816-2841
Fax: 978-921-7048
The Provider Relations Department will need the following items to bring a new provider to a meeting for approval to become a BILHPN – Beverly LCU member and link to our health plan contracts:
- Managed Care Participation Application
- Confirmation that Beverly Hospital privilege application is in process
- Completed Health Plan Participation Form
- Collaborative Agreement (for Advanced Practitioners Only)
- Board Eligibility Letter (if provider is not yet Board Certified, or going through recertification)
- W-9 (for new practices only)
- Participating providers completion of the Care Retention, Ownership Interests and Release of Information (Beverly | Winchester LCUs)
Please send required documents to Alycia Messelaar, Alycia.Messelaar@lahey.org. If you have questions regarding the LCPN on-boarding process, please call 978-236-1784.