FORMS
This page provides Adobe 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.
Physicians log into the website here.
Allied Health log in
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
or allied health application portal, you
can proceed to the login screen
here. (The URL for this portal is
https://tpqvo.com/secure/physician_login.php for physicians or
https://tpqvo.com/secure/allied_login.php for allied health providers. )
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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