Get How To Update Provider Address Forms For Opticare

Updating your provider address is essential for ensuring proper communication and service delivery. This guide provides a clear step-by-step process for filling out the How To Update Provider Address Forms For Opticare online, ensuring your information is accurate and up-to-date.

Follow the steps to accurately complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the primary office location or branch office location as applicable. If listing branch offices or separate legal entities, be prepared to complete additional forms.
3. Fill in the practice or group legal name (contracting entity) and the practice name for directory purposes, if different. This ensures the correct identification of your practice.
4. Provide the Tax ID number; note that each Tax ID requires a separate W9 form and contract.
5. Indicate if the site is a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC) by selecting the appropriate option.
6. Enter the Group or Billing NPI (National Provider Identifier) in the designated field.
7. Fill in the office address, suite number, city, state, and zip code. Ensure to include the county as well.
8. List the phone and fax numbers for the office. This helps maintain effective communication.
9. Provide an email address for the office, which will be used for correspondence.
10. Complete the office details section, answering whether the location is handicap accessible and noting the office hours for each day of the week.
11. Indicate if you are accepting new patients and any age limitations to patient care.
12. Note if there is a system for 24/7 on-call availability and list any languages spoken in the office.
13. If the location is affiliated with a separate optical store or retailer, provide the name of that establishment.
14. If your billing or correspondence office information differs from the practice location, fill in that information.
15. List the doctors who provide services at this location, including their credentials and identification numbers such as Medicare and Medicaid numbers.
16. If applicable, indicate whether further credentialing is required for any current or new providers at the practice.
17. Review all entries for completeness and accuracy to prevent delays in claims processing.
18. Once all sections are completed, save changes, download, print, or share the form as necessary.

Complete your updates promptly by filling out the How To Update Provider Address Forms For Opticare online today.