Get Hcas Form

Filling out the Hcas Form online is a straightforward process that allows providers to enroll conveniently. This guide will walk you through each section and field of the form, ensuring that you complete it accurately and efficiently.

Follow the steps to complete the Hcas Form online.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin with the provider information section. Enter your full name, including first, middle, last, and any suffix. Fill in your CAQH ID, degree or title, social security number, date of birth, specialty, license number, and DEA number. Choose the appropriate gender from the options provided.
3. Continue with the national provider identifier (NPI), Medicare/Medicaid number, and primary hospital affiliation. Indicate if you are a primary care provider or a specialist and enter your staff position.
4. Complete the practice information section by entering the practice name, address (including street, city, state, and zip code), and contact details like telephone and fax numbers. Specify the languages you speak and provide your email, as well as the name and contact information of the practice manager.
5. If applicable, list any additional practice addresses. Include details such as street address, city, state, telephone, fax number, and languages spoken by office staff.
6. In the payment information section, provide the payee name, tax identification number, and payment address details. Include contact information such as telephone, fax, email, and contact name.
7. Indicate whether the provider practices exclusively in a facility setting and if they accept direct referrals from clinicians. Answer if the provider needs to be listed in directories.
8. Fill in optional practice information such as office hours and average waiting time for initial visits and routine physicals. Include covering physicians' names and specialties if necessary.
9. Respond to questions about whether the provider is accepting new patients, participates in Medicare, and list any practice restrictions. Indicate the age groups treated.
10. Finally, submit the completed form along with any additional documents required by the health plan. You can save changes, download, print, or share the form as needed.

Start completing the Hcas Form online today to ensure a smooth enrollment process.