MetroCare is continuing to assist our providers with maintaining their direction in the midst of a constantly changing healthcare environment.
This year, MetroCare continued our mission to enhance the satisfaction of patients, providers, and purchasers through a value-based, patient-centered, and physician-led approach.
We provided, and will continue to provide, many services included as a part of your membership:
- Coding and documentation education for ICD-10, CPT, HCC, and chart auditing
- Web-based education resources
- Value-based healthcare education and practice support
- Population health support
- Centralized credentialing for Cigna, UHC, and Trilogy networks
- Value-based contracts with Cigna and UHC (for CIN members)
- Representation from HealthChoice for claims issues (with our contracted payors)
Credentialing
The credentialing process at MetroCare generates a file that serves as delegated credentials with multiple payers in the HealthChoice Network. Thus, it may be more rigorous than an application process for a single payer.
The credentials committee meets monthly to evaluate and approve completed files. The process from submission of a completed application to committee approval may range from 45-60 days, depending on the difficulty of obtaining verifications and peer evaluations.
Requesting an Application
Health Choice/MetroCare is the Methodist affiliated network. Providers are required to use HealthChoice network facilities as well as HealthChoice network providers for ALL services related to HC patients/HC network contracts.
Please review the requirements below before requesting an application.
- Current, unrestricted TN, MS or AR license to practice
- Current, unrestricted DEA for any state. DEA must be transferred to current state of practice location prior to completion of credentialing process.
- Providers must be board certified or board eligible in their practice specialty
- Most providers should have HC network facility privileges or have application in process. If not, please review the following requirement:
- If applicants do not have admitting privileges at a network hospital, you must provide the name of a network provider (of your specialty OR a network hospitalist provider that meets our requirements and has admitting privileges at a network participating hospital) who has agreed to provide coverage for you. There are certain specialty providers that MUST have privileges at a HC network hospital.
If the applicant meets all of the above listed requirements, then proceed to the next step.
Email our Credentialing Manager, Kelly Jordan This email address is being protected from spambots. You need JavaScript enabled to view it. to request an application.
You must include the following information in your email:
- Provider Name
- Provider Degree
- Provider NPI
- Specialty
- Board Certification
- Covering Physician
- Supervising physician (for extenders)
Physician / Practice Records Change
Changes such as group affiliation, physical location, remittance address, telephone or fax need to be submitted by the fifteenth of the month to be reported to payers for that month.
Early submission may help prevent claims issues.
A change in group affiliation, or any change of TIN (tax ID) requires a copy of the current W-9 in addition to the MetroCare Change Form.
Questions? Please call 901.360.1360 or email This email address is being protected from spambots. You need JavaScript enabled to view it.