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How to fill out the Imd Primewest Form online
Filling out the Imd Primewest Form online can seem daunting, but it is a straightforward process when approached step by step. This guide provides detailed instructions on how to accurately complete each section of the form to ensure smooth submission.
Follow the steps to complete the Imd Primewest Form online.
- Click the 'Get Form' button to obtain the Imd Primewest Form and open it in your preferred format.
- Select one provider type code from the list provided on pages 2-4 that best identifies the provider, whether an individual or facility.
- Enter the provider’s National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) in the designated field.
- If applicable, input the individual provider’s Unique Physician Identification Number (UPIN) assigned to certain healthcare professionals.
- For pharmacies only, enter the NCPDP (National Council for Prescription Drug Programs) number in the specified section.
- Provide the office telephone number, ensuring to include the area code for accurate contact information.
- Complete the Provider Name field, entering either the business name for facilities or the individual’s name as it appears on state-issued identification.
- Fill in the practice address, ensuring it reflects the actual physical business location. A P.O. Box is not acceptable.
- If available, enter the federal employer identification number (FEIN) associated with the provider.
- Indicate the business name connected with the FEIN in the Taxpayer Name section.
- For individual practitioners, include the Social Security Number in the corresponding field.
- Specify the county where the provider’s main practice or business office is located, identifying any Indian reservations if applicable.
- Refer to the list on page 5 to indicate the provider’s specialty and code, entering any certification numbers and their dates if the provider is board-certified.
- Provide detailed license, certification, permit, or registration information including numbers, issuance dates, and expiration dates.
- Finally, after verifying all entries, save the changes, and choose to download, print, or share the completed form as required.
Complete your Imd Primewest Form online today for efficient and accurate processing.
Timely filing for PrimeWest refers to the requirement of submitting claims within a specific period following the provision of services. Understanding this limit is crucial for ensuring your claims are processed without delays. When working with documents like the Imd Primewest Form, remember that keeping these timelines in mind can help you avoid complications.
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