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Get Waiver Request Form

E Act (ASCA) Waiver Request Form Per CMS guidelines, providers are to self-assess to determine if they meet one or more of the situations listed below. If approved by NHIC, Corp, you will be allowed to continue sending paper claims. Please note that some of these situations are temporary. When the temporary situation expires, providers must submit their claims electronically, and according to HIPAA standard. To indicate that your provider/supplier meets an ASCA exception, please complete this fo.

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