Turn on more accessible mode
Turn off more accessible mode
Skip Ribbon Commands
Skip to main content
Find a physician
|
Search
|
Health Information Library
Who We Are
For Seniors
Choosing a Brown & Toland doctor
Find a Physician
Ask-A-Nurse
9 Reasons why you need to choose a Brown & Toland Physician.
Affiliated Health Plans
Affiliated Hospitals
Our Medical Services
iHealthRecord
Recommended Health Links
Physician Practice Solutions
For Health Care Brokers and Employers
Publications
Frequently Asked Questions (FAQ)
Open Enrollments & Benefits Fairs
Clinical Results Reporting (CRR)
BT C.A.R.E. User Account Request Form
City and County of San Francisco
Medi-Cal
CMS Provider Dispute Resolutions
Our Mission
Our History
Our Executives
Keep Your Doctor When You Turn 65
Top 10 Things You Should Know About Medicare
HMO Plans
PPO Plans
Medicare Advantage Plans
Disease Management
Case Management
Utilization Management
Asthma / COPD Management
CHF Management Program
Diabetes Management
HIV Management
Wellness Programs
Practice Management System
Billing Service
callout
Page Content
Back to BT C.A.R.E. User Account Request Page
Request Form
For questions about this form, please call 415.972.4350 or email credentialingdept@btmg.com
Personal Information
*First Name:
Middle Name:
*Last Name:
Your Email:
Contact Office Information
*Primary Office Address:
*Primary Office Phone:
ext:
Primary Office Fax:
*Office Manager Name:
*Office Manager Phone:
ext:
Practice Information
*Practice Name:
*TIN:
For Multiple TINs
Provider Name:
TIN:
Provider Name:
TIN:
+ Add another provider
Require BrownandToland.com Log on?
Physicians can access Brown & Toland’s secure provider portal located on www.browandtoland.com for information on fee schedules, clinical guidelines, ancillary provider listings, references and forms, Brown & Toland communications and updates pertinent to running your practice and providing care to our members.
If you do not have log in, do you need one?
Yes
No
Require Clinical Results Reporting?
Clinical Results Reporting (CRR) provides physicians and their staff with a single location to review laboratory reports, dictated reports, and radiology results for their patients. Results are available for both Brown & Toland and non-Brown & Toland patients.
Fill out this section if you would like to have access to Clinical Results Reporting (CRR)
Yes
No
DISCLAIMER
I understand that information contained on the Brown & Toland’s BT C.A.R.E. is protected and confidential and intended only for the use of Brown & Toland contracted providers and their authorized office staff. I agree to educate my staff on the appropriate use and confidentiality of the Brown & Toland BT C.A.R.E. information. I agree to notify Brown & Toland in writing of any changes to the above staff list. I understand that any unauthorized access, distribution, or copying of information contained on the website is strictly prohibited and subject to Brown & Toland pursuing appropriate action, which could range from restricted access to legal sanctions.
I agree:
rightside
Copyright © Brown & Toland 2004