Get First Choice Provider Credentialing Phone Number Form
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How to fill out the First Choice Provider Credentialing Phone Number Form online
Completing the First Choice Provider Credentialing Phone Number Form online is an essential step for healthcare providers seeking to join a managed care organization. This guide will outline the necessary steps to efficiently fill out the form, ensuring that you provide accurate and complete information throughout the process.
Follow the steps to successfully complete the form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your personal information in Section I, including your name, place of birth, and contact details. Make sure to provide both your Social Security number and NPI as required.
- In Section II, provide your medical license and registration details. Indicate if you offer OB care and specify any foreign languages you speak fluently.
- For Section III, fill out your education, training, and hospital privileges. List the institutions where you studied, along with relevant dates and degrees earned.
- Continue to Section IV to document your medical specialties. Indicate your board certifications and any planned examinations.
- In Section V, enter your malpractice information, listing carriers and coverage details for the past five years.
- Section VI requires a detailed work history for the past five years. Be sure to include explanations for any employment gaps.
- Complete Section VII by answering background questions thoroughly. Each answer may require a written explanation if negative.
- In Section VIII, review and provide authorization for the Managed Care Organization to conduct necessary background checks. Ensure your signature is included where specified.
- Finally, review the entire form for accuracy, save any changes, and proceed to download or print it for your records.
Start completing your credentialing documents online today for a smoother onboarding process.
For all inquiries regarding the First Choice Health Network, you can dial 1-800-676-2583. This helpline provides you with important answers and support regarding your health network. Additionally, to handle any related credentialing questions, the First Choice Provider Credentialing Phone Number Form serves as a valuable resource.
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