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New Member

Physicians holding privileges at any Methodist Healthcare System facility are invited to join Methodist Physician Alliance (MPA). Membership gives you the power of the messenger model process, negotiating discounted fee-for-service contracts relative to your stated preferences. With a current network of over 1,200 physicians, MPA holds contracts with 9 managed-care payors.

If you are not already a member of MPA, please complete this preapplication form to initiate the enrollment process. There is a one-time application fee of $250 per provider to join our network. You will have to submit a current Texas Standardized Credentialing Application (which can be downloaded from <www.tdi.state.tx.us>) with a copy of your current credentials.

Currently, we only credential M.D.’s, D.O.’s, D.P.M.’s, and D.D.S.’s with educational training in oral maxillofacial surgery (we do NOT credential mid-level providers).

Step 1Download the Pre-Application Form here.

Step 2: Pay the $250 membership fee:

Notes/Comments

Note: If ordering multiple memberships, change the quantity and add the names in the note/comment field above

Minimum Requirements:

  • Please make the $250 application fee payable to Methodist Physician Alliance. This fee is non-refundable.
  • Applicant must have medical staff privileges with at least one Methodist Healthcare System facility (hospital or ancillary).
  • Medical Malpractice insurance coverage is required (minimum liability limits of $200,000/$600,000).

Once we receive your completed application, your application must be reviewed and approved by MPA’s credentialing committee. The entire process can take up to 120 days to complete. Providers will be notified by mail once the process is complete.

Existing Member

Providers are asked to keep ALL demographic information current with MPA at all times as we must forward any changes to the payors that you are contracted with through MPA as this could affect their ability to pay your claims. We must be notified of any changes to the following demographic information:

  • Tax ID (we will require a new W-9 form)
  • Practice Location(s)
  • Notification of any additional practice location(s)
  • Remittance/Billing Address (we will require a new W-9 form)
  • Phone and Fax numbers

Membership Renewal ($75):

Notes/Comments

 

If you have any questions on membership information, please contact our office at 210-575-0252.

 


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