 First Choice Health Home : PPO Network : For Providers : Provider Application
First Choice Health is a Preferred Provider Organization (PPO) serving the Pacific Northwest.
We offer access to our network of quality healthcare providers to various contract holders, or
payors, such as commercial insurers or third party administrators, that sponsor employer groups'
access to our network of providers in Washington, Alaska, Idaho and Oregon as part of their benefit plan.
All healthcare professionals must successfully complete our comprehensive credentialing
process to be accepted as a First Choice Health (FCH) Preferred Provider. This process
ensures that all providers in the network meet a specific set of standards before
they are approved to render services to the members utilizing our network. In certain
instances, FCH delegates the provider credentialing process to organizations recognized
for being in compliance with our credentialing standards.
To begin the credentialing process, please complete our standard application. We
accept the Washington Practitioner Application (WPA) for all providers located in
Alaska, Idaho, Oregon and Washington.
All applicants MUST review the Provider Credentialing Requirements and Information
prior to submitting an application.
Provider Credentialing Applications
If you have already completed one of the Credentialing Applications reference above,
FCH will accept that application as long as it is current and completed in its entirety.
Provider Group Agreement
Participation with FCHN requires the signature of an authorized contact person and date.
The Agreement MUST be returned along with the credentialing application.
Once we receive your completed application, we will verify education, licenses,
practice history, professional liability coverage, hospital affiliation, malpractice
history, and any history of sanctions. Participation in the FCH PPO Network depends
upon the results of the verifications and of review of your application by our Credentialing
Committee. The committee meets the second Wednesday of each month and our average
time for processing applications is 90 days from receipt.
If you successfully complete the credentialing process, you will be notified in
writing of your effective date with FCH PPO Network. Effective dates are not assigned
retroactively and are not determined by the date you submit your application, sign
your contract, or begin your practice. Once credentialed, providers are then scheduled
to be re-credentialed every three years. We will automatically send you the re-credentialing
materials prior to your three-year anniversary date.
If you are a large group of health care professionals, your group may be eligible
for network participation based on Delegated Credentialing.
Additional Information
To obtain additional information about our credentialing requirements and how to join
First Choice Health Network, please contact our Credentialing Department at 1-800-231-6935
extension 2106 or e-mail us.
- To obtain a Sample Fee Schedule, please call Provider Relations at 1-800-231-6935 extension 2103.
- To download a W-9 Form, please visit the Forms and Publications
page of the Internal Revenue Service Website and select "Form and Instruction number ".
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