Get Ihcp Group And Clinic Provider Enrollment And Profile Maintenance ...

Filling out the IHCP Group and Clinic Provider Enrollment and Profile Maintenance form online can be a straightforward process if you follow the right steps. This guide provides clear instructions on how to navigate each section of the form, ensuring you complete it accurately and efficiently.

Follow the steps to complete your IHCP provider enrollment online

1. Click ‘Get Form’ button to obtain the form and open it in your editor of choice, allowing you to fill it out easily.
2. Read the instructions carefully in each section of the form before beginning to fill it out to ensure you understand the requirements.
3. Complete all mandatory fields in Schedule A, including your legal name, Taxpayer Identification Number, and contact information.
4. In the Provider Information section, ensure you include your National Provider Identifier (NPI) and other relevant identifiers accurately.
5. Provide complete information for any additional specialties or taxonomies you may have, ensuring they correspond with your rendering provider details.
6. If you are adding a service location or making changes, make sure to complete the relevant sections detailing the service location's name and address.
7. Go through the required addenda and complete the necessary fields for each, attaching supporting documentation where requested.
8. Review your completed form for accuracy, ensuring that all required fields are filled and necessary documents are included.
9. Print the completed packet and make a copy for your records.
10. Mail the completed form and all attachments to the specified address provided in the instructions, ensuring it is sent in the correct page order.

Start completing your IHCP Group and Clinic Provider Enrollment and Profile Maintenance form online today!