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Y Teladoc To file a claim: Temporary Disability Insurance P.O. Box 20100 Cranston, RI 02920 Rhode Island Department of Labor and Training www.dlt.ri.gov 401-462-8420 Selman & Company 6110 Parkland Boulevard Cleveland, Ohio 44124 1-800-638-2610, option 1 Tricare Supplement Telemedicine Accident Insurance Claims Address: P.O. Box 2150 Rockville, MD 20847 www.selmantricareresource.com memberservices selmanco.com 1-800-TELADOC www.teladoc.com/doctornow 1-855-267-6971 www.saicbenefits.com.

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How to fill out the Provider Contact List online

Filling out the Provider Contact List accurately is essential for ensuring that you have up-to-date contact information for your healthcare providers. This guide will take you through the step-by-step process of completing the form online, ensuring that you can efficiently gather and maintain necessary information.

Follow the steps to complete the Provider Contact List.

  1. Click ‘Get Form’ button to obtain the form and open it in the appropriate online interface.
  2. Review the introduction section of the form to understand the purpose and importance of the Provider Contact List.
  3. In the Vendor section, carefully enter the names of the healthcare providers you use. Be sure to include both primary and secondary options if applicable.
  4. Proceed to fill in the Plan information, specifying the coverage types such as Dental HMO, Dental PPO, etc.
  5. Complete the Contact Information section by entering details including the PO Box, city, state, and zip code for each provider.
  6. Enter the website URLs and phone numbers accurately to ensure you have easy access to additional resources.
  7. Continue to fill out any additional sections as needed, ensuring that all required fields are completed accurately.
  8. Review all entered information for accuracy before submitting the form.
  9. Once you are satisfied with the filled form, save your changes, and choose to download, print, or share the document as needed.

Start filling out your Provider Contact List online today to ensure you have all your important healthcare information at hand.

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Overview. Your Medicare Part A and B claims are submitted directly to Medicare by your providers (doctors, hospitals, labs, suppliers, etc.). Medicare takes approximately 30 days to process each claim.

Visiting MyMedicare.gov. Calling 1-800-MEDICARE (1-800-633-4227) and using the automated phone system. TTY users can call 1-877-486-2048 and ask a customer service representative for this information. If your health care provider files the claim electronically, it takes about 3 days to show up in Medicare's system.

What is a Medicare Provider Number (MPN)? A Medicare/Medicaid Provider Number (MPN) verifies that a provider has been Medicare certified and establishes the type of care the provider can perform. This identifier is a six-digit number.

1-800-MEDICARE (1-800-633-4227) Get this form in Spanish.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232