Get Howard University Third Party Billing Contract

Filling out the Howard University Third Party Billing Contract is essential for ensuring that your tuition and fees are covered by a third party payer. This guide provides clear, step-by-step instructions to help you complete the form efficiently.

Follow the steps to complete the Third Party Billing Contract accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the date you are completing the form in the designated field. This helps track when the contract was submitted.
3. Provide your Howard Student ID. If you do not have it, look for it in your university documents or online portal.
4. Fill in your full name in the Student Name field as it appears in university records.
5. Input your daytime phone number, ensuring it is a number where you can be reached easily.
6. Enter your Howard email address in the corresponding field. This is important for official communications.
7. Specify the name of the third party payor organization that will be covering your costs.
8. Provide the payor student ID number, if applicable, under the Third Party Payor ID# section.
9. Include the contact name for the third party payor, ensuring it is someone who can assist with inquiries.
10. Complete the Third Party Payor Mailing Address, filling in the street address, city, state, and zip code.
11. Fill in the third party phone number with the appropriate format and number.
12. Select the semester(s) for which this contract applies by marking the relevant options.
13. Indicate the amount that will be covered by the third party payor, either as a percentage or a specific dollar amount per term.
14. Confirm whether you have provided the authorization or award letter by selecting 'YES' or 'NO.'
15. Indicate if the invoice is for tuition only, and select 'YES' or 'NO' as applicable.
16. Determine if housing should be included in your invoice selection and confirm accordingly.
17. If applicable, indicate whether you require a book voucher, only if it is authorized by the third party payor.
18. State if meal plans should be included in your invoice by selecting 'YES' or 'NO.'
19. List any additional fees that need to be covered outside standard fees, if applicable.
20. Read the confirmation of agreement statements carefully. These clarify your responsibilities and the understandings between you and your sponsor.
21. Sign the form to acknowledge your consent and understanding of the terms outlined.
22. Provide the date of your signature.
23. Once all information is complete, review the entire form to confirm accuracy before submission. You may then save changes, download, print, or share the form as necessary.

Complete your documents online today to ensure timely processing.