Get Medco 13

Completing the Medco 13 form is an essential step for providers seeking certification with the Bureau of Workers’ Compensation (BWC) in Ohio. This guide will provide you with clear, step-by-step instructions on how to accurately fill out the online form to ensure your application process runs smoothly.

Follow the steps to complete the Medco 13 form online.

1. Press the ‘Get Form’ button to access the Medco 13 form and open it in your preferred form editor.
2. Begin with Section 1 by selecting your provider type. Review the types listed and choose one that accurately represents your qualifications. Make sure to fill out any additional sections as required for your selected type.
3. In Section 2, provide your general information. This includes your current BWC provider number (if known), business NPI number, tax identification number, and personal details such as your social security number. Ensure all names and identifiers match official documents.
4. In Section 3, detail your individual provider information. Provide your education and training history, including any specialties and certifications. Attach any required documentation, ensuring accuracy.
5. Proceed to Section 4 to answer questions about your professional history and any potential impacts on your ability to practice. Be thorough and provide explanations where necessary.
6. Finally, in Section 5, read and acknowledge the provider application/agreement. Fill in your authorized signature and provide the date. Attach any additional required documents alongside your application.
7. Once the form is completed and thoroughly reviewed, you can save changes, download the form, print it for your records, or share it as instructed or necessary.

Complete your Medco 13 application online today to ensure your qualification as a certified provider.