Get Tn Bcbs Form 17ped132325 2017-2025
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How to fill out the TN BCBS Form 17PED132325 online
Filling out the TN BCBS Form 17PED132325 is an essential step for Nurse Practitioners and Physician Assistants working in pain management. This guide provides a clear and detailed step-by-step approach to help you complete the form efficiently and accurately.
Follow the steps to complete the TN BCBS Form 17PED132325 online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by providing information about your practice setting. Clearly indicate where you will be working, so reviewers understand the context of your practice.
- Next, answer whether you will perform spinal injections and procedures, including blocks of major peripheral nerves of the spine. Select 'Yes' or 'No' as appropriate.
- If you selected 'Yes,' specify how you will be supervised while performing these procedures. This information is crucial for compliance.
- Then, enter the name and specialty of your supervising physician. Ensure this is accurate as it is linked to your credentialing process.
- You must attest that the listed supervising physician will always be physically present in the same building during the procedures. Make this selection to confirm.
- Finally, sign and date the form where designated, confirming that all information provided is correct. Keep a copy of the filled-out form for your records.
- Once completed, you can save changes, download, print, or share the form as needed.
Complete your documents online now to ensure timely processing of your credentialing application.
BlueCross BlueShield of Tennessee is not a Medicaid program; rather, it offers private health insurance plans. However, BCBS TN does provide Medicaid managed care services to eligible low-income individuals in Tennessee. If you receive services through BCBS TN Medicaid, it’s essential to submit the appropriate forms like the TN BCBS Form 17PED132325 to ensure coverage. Understanding your plan helps you maximize the benefits available to you and your family.
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