Get Realtime Provider Information Form - Emdeon

Filling out the Realtime Provider Information Form - Emdeon is a crucial step in ensuring accurate updates to your provider information. This guide provides step-by-step instructions to help users complete the form efficiently and effectively.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Realtime Provider Information Form - Emdeon and open it in your preferred online format.
2. Begin by filling out the Customer Number, Provider Organization, Provider Name, Practice/Facility Name, and Tax ID. Ensure all information is accurate to avoid delays.
3. Complete the address section by providing the Street Address, Zip Code, City, and State. Double-check for spelling errors or incorrect information.
4. Enter the Contact Name, E-mail Address, Telephone, and Fax numbers in the designated fields. This information is crucial for communication regarding your submissions.
5. For the Payer section, accurately fill in the Payer Name/ID and any relevant group or individual provider IDs as required by your organization.
6. In the Confirmations section, confirm where Change Healthcare Claim Confirmations should be sent and add any special instructions if applicable.
7. Review all sections for completeness and accuracy. Remember, signatures are necessary where applicable, and stamped signatures or photocopies are acceptable.
8. Once completed, you can save changes, download, print, or share the form as needed, ensuring it is submitted to the appropriate email or fax number provided.

Take action now and fill out your forms online for swift processing.