Primary Care, Specialty, and Ancillary Providers
Thank you for your interest in Select Health Plan.
Select Health Plan serves the Medi-Cal Managed Care, Commercial HMO, Covered California, and Medicare Advantage population in Los Angeles County predominantly in and around Long Beach and the South Bay. To become a Select Health Plan Provider, Primary Care Physician, Specialist, or Ancillary Providers should submit your Letter of Interest, CV(PCPs and Specialists only), and a W-9 to:
MemorialCare Select Health Plan
ATTN: Network Management Department - Contracting
17360 Brookhurst Street
Fountain Valley, CA 92708
Fax to: (562) 424-1614
Email: [email protected]
Questions? Call: (657) 241-3900.
Note: PCPs and Specialists are required to be Board Certified or Board Eligible (for new graduates who just finished their residency).
Your Letter of Interest should include the scope of practice or services, hospital and/or outpatient surgery center privileges, any other unique aspects or focus of your practice. Examples may include focusing on a specific population in your specialty (Pediatrics vs. Adult), UroGyn only-no OB, Aquatic Therapy, etc. Ancillary Providers should include the services available, your locations(if applicable), and your in-network contract status with the primary health plans by line of business in LA County(i.e. Health Net, Anthem, Blue Shield, LA Care; HMO, Covered CA, Medi-Cal Managed Care, Medicare Advantage).
Once your information is received, we will review your packet and evaluate it based on the needs of our network. Should a need arise; we will contact you for consideration. If we do not have a current need, we will keep your information on file for one (1) year.
Please feel free to follow up in 4 weeks after your submission.
Thank you again for your interest in MemorialCare Select Health Plan.