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Network Provider Contracts and Applications


HealthChoice


Facility

Ambulatory Surgery Center Contract (HCASCCv2.2)
Long-Term Acute Care Facility Contract (HCLTACFCv1.1)
Network Facility Contract (HCFCv1.1)
First Amendment of OSEEGIB Network Facility Contract (HCFCv1.2)

*Radiology and Sleep Study Providers must complete and sign the First Amendment of the OSEEGIB Network Facility Contract. The amendment must accompany a completed Network Facility Application and signed signature page when it is submitted to OSEEGIB Provider Relations to complete the application process. If the amendment is not received as an attachment to the application, it will be considered incomplete which will delay your effective date as a Network Provider.


Department of Rehabilitation

Network Contracts

Department of Corrections

Network Contracts