Revised Change of Ownership-CHOW Form now available

March 29, 2019

The Consent to Assignment of Provider Contracts — Change of Ownership (CHOW) form has been revised. This form is used to process a change of ownership for a Hospital and/or Ancillary Provider. The enhancement includes a listing of required documents needed to process the change. We also included links to the Electronic Commerce and Availity Sections of our website to ensure that any revised paperwork can be submitted at the same time.

Please contact your Network Management Representative if you have any questions about filling this form out.