Forms & Resources Information, Forms, and Helpful Links

Please see the resources below for First Choice Health's communications regarding updates on Change Healthcare's cyber response. 

Stay informed with UnitedHealth Group's latest information on the Change Healthcare Cyber Response.

First Choice Health has partnered with the Consumer Reports Choosing Wisely campaign, which provides tools and resources to help you talk about your care options with your doctor(s) to ensure you receive care that's right for you.

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FCH allows providers to pre-check coding logic with Clear Claim Connection (via OneHealthPort) to ensure smooth and timely processing of submitted claims.

Enroll through Zelis for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA/835) processing. For more information or assistance, contact a Zelis Provider Enrollment Advisor by calling (855) 774-4392 or email [email protected].

First Choice Health does not automatically renew fee schedules on an annual basis. We will advise our contracted providers when a new fee schedule becomes effective. If you would like a copy of your existing fee schedule, please email [email protected].  In order to complete your request please include your Tax ID and NPI numbers.

First Choice Health Medical Management offers providers a variety of tools and resources to assist with patient care. Contact our Intake Coordinators by phone (800) 808-0450 or by fax (888) 272-3289

View the List of Payors and/or Sign up to receive email alerts when the monthly List of Payors is published.

Medical policies are used by our Medical Management clinical staff to ensure decisions are made in an unbiased and consistent manner that best serves the interests of First Choice Health participants. Medical policies are not intended to offer medical advice or replace medical judgment.

Search our Medical Policy Library

The Nebraska Health Network waiver request is an opportunity for providers participating in the Nebraska Health Network to submit a request for enrolled members to see an Out of Network provider at In-Network Tier 2 pricing. The requesting provider must complete and sign the form below. Instructions on where to submit the completed form can be found on the form itself. Once a decision is made, both the member and provider will be notified by letter of the outcome.

Waiver form

For questions, contact First Choice Health at 1-800-517-4078 or [email protected]

We encourage First Choice Health members to take advantage of Preventive Care Services. Routine checkups and screenings can help you avoid serious health problems, allowing you and your doctor to work as a team to manage your overall health, and help you reach your personal health and wellness goals.

View bulletins and/or Sign up to receive email alerts when bulletins are published.

The First Choice Health Provider Manual provides the basic information you and your office staff need when seeing FCH PPO patients as well as direction and clarification regarding your obligations as a FCH PPO provider.

View newsletters and/or Sign up to receive email alerts when newsletters are published.

Terming an existing practice address:

  • Send an email to [email protected] indicating you wish termination of a specific practice address. 
  • Include your NPI and Tax Identification numbers so we can find you in our system.

Changing/adding a billing address: 

  • To update this address type, send an email to [email protected] indicating you wish to change your billing address. 
  • Include your NPI and Tax Identification numbers so we can find you in our system.

Important Note - A billing address means the "pay to address" or where the checks need to be sent. It should match what is being sent in box 33 on the CMS 1500 or EDI form locator 2010AA (street address) or 2010AB (PO Box). 

Tax Identifier Number changes: 

  • If you are joining an existing TIN that is contracted with FCH:
    • Your new Tax ID (TIN) information must be reflected on your online application.
    • Update the application and attest and we will update your demographic information.
  • If you are adding a brand new TIN to FCH: 
    • Add it to your application and attest. 
    • Then, email a W9 to [email protected] along with messaging indicating that you have added a new TIN.
  • If you are terming an existing TIN: 

All other changes not listed above (new practice address, name change, specialty change, etc.): 

  • Ensure your demographics are correct and accurate on your CAQH application.  
  • Once all your information has been updated and attested to, we will automatically get the updates and make the change in our system within 2 business days.

Access tutorials and webinars designed to help providers and office staff navigate our website and utilize the tools offered to them.

We offer short tutorials to assist users with the following tools:

  • Benefits and Eligibility
  • Claim Status
  • Priced Claim Status
  • Payor/Employer Group Search
  • FCH Benefits and Eligibility
  • FCH Claim Status Inquiry

We also offer an in-depth webinar that covers topics such as:

  • PPO Network Business Model
  • How to look up a payor/employer group by name or number
  • How to obtain claim status
  • How to obtain Benefits and Eligibility
  • Payor web links
  • When to call Provider Relations for assistance
  • ID card samples

These tutorials and webinar are helpful for all providers and office staff.

FCH Providers who have opted in for Weekly Claims Activity Reports can view the reports.

Reports are run every Monday and summarize all claims priced by FCH for your billing office (determined by Tax Identification Number).

Reports include the following information:

  • How the claim was received for pricing (batch type)
  • When the claim was received and completed
  • The FCH allowed amount
  • Disposition of the claim (forwarded on for processing or returned for errors)
  • Error codes associated with the claim
    • Note that the error description line will indicate the charge line that is associated with that specific error.

Providers who have opted to receive this report will not receive any FCH paper pricing worksheets. The report is to be reviewed weekly and if any errors are identified, all associated claims should be corrected and resent to FCH for pricing.