FORMS
This page provides fillable initial application forms. For secure
application processing, you will need to go to the physician access portal.
For more information about secure application processing, you can review the
description of the TPQVO secure application processing website
here.
To log into the website, go
here.
Initial Credentialing Application Forms
Several area initial application forms are available on
this web site for downloading, filling and submission to TPQVO for processing.
Some TPQVO clients use their own forms or the applicable state universal
application forms. If you have any question about which form to use on
this web site, please do not hesitate to
contact
us.
Depending upon your region, you will select the appropriate form available for
filling and printing using Adobe® Acrobat® Reader™. (This program is
available for free download by clicking
here.) Other healthcare organization clients may use their own forms
or the applicable mandated state credentialing form.
If you
have already set up a file with TPQVO, you may use the physician application
processing portal to submit your application form via the secured part of this
website. You will need your login ID and password to enter the portal.
Recredentialing Applications and Schedule
Reappointment or recredentialing forms are not
available on this page. If you have received instructions
to process your reappointment application through the secure
physician application portal, you can proceed to the login
screen
here. (The URL for this
portal is
https://tpqvo.com/secure/physicianlogin.php.)
In Tennessee, most participating healthcare organization clients have
agreed upon the use of one standard application and recredentialing form.
In those areas, there is a standard recredentialing schedule based upon
specialty or professional discipline. For more information about
the area schedule, please click the hyperlinks below.
Confidentiality and Privacy
TPQVO maintains credentialing information under the strictest
confidentiality policies. Once we receive your information, we only
release it to those healthcare organizations you authorize in writing.
Questions?
Please feel free to
contact us with any questions you have about our processes and policies.
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