Registration - Provider Portal - Choice Physicians Network

Step 1 - Contact Information
Please enter the contact information for each user needing access.

First name	Last name	Email address	Phone number
				Delete

Step 2 - Company Access
Please check the boxes for the access you need for each company.

Code	Company	Check Eligibility	View Claims	View Auths	Auth Submission
Code	Company

Step 3 - Main Point of Contact
Please enter the contact information for the person authorizing this access, for example an office manager or doctor.

First name	Last name	Email address	Phone number

❌ = Contracting issue This means that the necessary contract agreements are not in place to allow your organization to perform this function. If you feel you should have this access, please contact our Contracting department at Contracting@ChoiceMG.com or call 760-242-7777 ext. 832.

I certify that all information provided is accurate and complete to the best of my knowledge, I am authorized to request such access, and the access requested is the minimum necessary for the effective performance of my designated role and responsibilities.