Nominate a Provider

You can nominate a provider by completing the information below or you can contact Healthcare Highways at 1-800-816-5356. If you contact us by phone, please provide some basic information and we will contact the provider and ask them to consider contracting with HCH Logix to become a Network Provider. The contracting process may take several months and the provider must meet our contracting standards. Your nomination does not guarantee the provider is eligible for participation in the network, or that they will agree to contract with us.

To check the status of your nomination, contact Healthcare Highways at 1-800-816-5356, or email us at: Please allow a minimum of 120 days before checking on the status of a Provider Nomination.

Referred By: * Required Field below
Name of member nominating a provider
Date of Nomination: *
Your First Name: *
Your Last Name: *
Name of your Employer: *
Your Email Address: *
Your Phone Number: *
Provider Information
Name of provider you want to nominate: *
Provider’s office street address: *
City: *
State: *
Zip: *
Provider’s office phone: *
Select State: *

Are you a member? Click here to nominate a provider.

Are you a provider? Click here to request a contract. See the form in the “Request a Contract” section.