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  • Interested Practitioner Request Form - Ohio Health Choice

Get Interested Practitioner Request Form - Ohio Health Choice

INTERESTED PRACTITIONER REQUEST Thank you for your interest in becoming a provider with Ohio Health Choice. Please take a few minutes to complete and return this form in order to evaluate our provider needs.

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Contact support

Contact the Ohio Health Choice Customer Service Department at 800-554-0027 for any questions regarding contracted rates, billing guidelines or network status. The claims appeal process is explained in detail in the “Claim Payment Resolution Issues” section of the Provider Manual (available here).

Pursuant to the OHC Facility and Provider agreements, if providers have an issue with a claim that needs to be reviewed for interpretation or application of the agreement terms, providers can contact our customer service at 1-800-554-0027 to initiate the claims appeal process.

Provider Resources Ohio Health Choice is provider owned and committed to serving our provider community. Here you will find all the tools and resources you will need to work with Ohio Health Choice to deliver the highest quality care to our members.

Ohio PPO Connect is a statewide PPO network sponsored by three leading provider owned networks (Ohio Health Choice, Quality Care Partners, The Ohio State University Health Plan).

Payer Name: Ohio PPO Connect|Payer ID: 74431|Professional (CMS1500)/Institutional (UB04)[Hospitals]

How do I check claim status? To check whether Ohio Health Choice has received or processed a claim, please contact the Customer Service Department at 800-554-0027. Ohio Health Choice is not a claims payor. For claim payment status, please contact the payor at the number listed on the member's ID card.

Ohio PPO Connect is the largest provider owned network in the state of Ohio. We combine unparalleled provider access with carrier competitive discounts and best in class customer service to produce tremendous savings and superior customer experience.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232