Network Credentialing Application

Complete the Health Choice Facility Non-Individual Provider Credentialing Application and return it to us with the requested attachments as well as the published fees/rates for your codes for our review. Please include any brochures or literature you may have about your product or service that will support your application. The information can be faxed to 901-821-4927, emailed to echolsd@myhealthchoice.com or mailed to 

    1661 International Place 
    Suite 150
    Memphis TN, 38120

After the information you have submitted has passed the verification process the information will be presented to the Health Choice Network Management Committee.  The NMC meets monthly and will determine if your facility will be asked to initiate the process of entering into a formal agreement.

Health Choice charges an annual network participation/access fee.  This fee is due at the time the contract is signed and annually thereafter on the anniversary of the effective date.  The access fee is determined by facility, specialty and provider type.  So, a facility that provides the same services you do is charged the same amount that you are for access to the network of patients.

If you have additional questions concerning the application, please do not hesitate to contact Debbie Echols directly at (901) 821-6744 or echolsd@myhealthchoice.com. 

1. Network Credentialing Application

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