Get Soonercare Provider Enrollment
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How to fill out the Soonercare Provider Enrollment online
This guide provides clear, step-by-step instructions on how to complete the Soonercare Provider Enrollment form online. Ensuring accurate information on this form is essential for efficient processing and enrollment with the Soonercare program.
Follow the steps to complete the enrollment form successfully.
- Click ‘Get Form’ button to access the enrollment form and open it for completion.
- Begin with Section I, Provider Information. Fill in your business name and address accurately, ensuring to include street address, city, state, and zip code.
- Provide your Provider ID or NPI number to identify your practice within the system.
- List the primary and secondary contact details. This includes the names, phone numbers, fax numbers, and email addresses of both contacts.
- Indicate your EDI vendor and check the appropriate vendor type, such as Software Product, Billing Agent, or Clearinghouse. Provide their contact details as required.
- In the transactions section, indicate which EDI transactions you wish to send or receive by marking the relevant options: 837 Professional Claim, 837 Institutional Claim, etc.
- Proceed to Section II if you are requesting an Electronic Remittance Advice (ERA). Choose whether to enable or disable the 835 Remittance Advice and fill in the necessary provider IDs and names.
- Elect a designated receiver for all ERA(s) by providing their ID, name, contact person, phone number, and email.
- Review the acknowledgment statement regarding the transition from paper to electronic remittance advice. Ensure you understand the terms before signing.
- Finally, complete Section III by signing and dating the form to validate your request. Verify all information is accurate before submission.
- Once completed, save the form in your preferred format. You have the option to download, print, or share the completed document as needed.
Complete your Soonercare Provider Enrollment online today to ensure timely and efficient processing.
To get credentialed through Medicaid, begin by researching your state's specific requirements. Collect the necessary documents, and fill out the application for SoonerCare Provider Enrollment accurately. After submission, be aware that the review process might involve back-and-forth communication for clarifications or additional information. To simplify your credentials journey, consider the tools and resources available through uslegalforms.
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