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Credentialing: Become a Participating Provider

In order to provide services to First Choice members as a participating provider, practitioners must first be credentialed by Select Health.

Select Health maintains and adheres to all applicable state and federal standards and regulations, South Carolina Department of Health and Human Services requirements and accreditation requirements governing credentialing and recredentialing functions. 
 
Practitioners are required to be recredentialed every three years. 

Providers can use the online credentialing application through CAQH. You will need your CAQH ID number.

Credentialing Forms:

Practitioner Credentialing Packet 

• Provider Data Record Checklist  
• SC Uniform Managed Care Provider Credentialing Application
• Claim Information Form
• Credentialing Attestation and Release Form
• Provider Participation Form
• Hold Harmless Agreement
• Collecting Provider Race, Ethnicity and Language Data
• Disclosure of Ownership Form

Facility/Ancillary Provider Credentialing Application

Recredentialing Forms:

Practitioner Recredentialing Packet

• SC Managed Care Credentialing Update Form
• Claim Information Form
• Credentialing Attestation and Release Form
• Office Hours/Patient Loads Form
• Additional Practice Locations Form
• Collecting Provider Race, Ethnicity and Language Data
• Disclosure of Ownership Form

Facility/Ancillary Provider Credentialing Application