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Get Xerox Cdr & Pcsr Request Form
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How to fill out the Xerox CDR & PCSR Request Form online
Filling out the Xerox CDR & PCSR Request Form online can streamline the process of obtaining important reports. This guide will provide you with comprehensive steps and helpful information to assist you in completing the form accurately and efficiently.
Follow the steps to fill out the form correctly
- Press the ‘Get Form’ button to access the Xerox CDR & PCSR Request Form and open it for editing.
- Begin by completing the requestor information section. Fill in the provider or facility name, provider address, and your name as the requestor. Additionally, enter the date requested, your phone number, and your email address for contact purposes.
- In the delivery method section, indicate whether you want to receive your reports electronically or via CD. If you choose CD, be aware of the $30.00 shipping fee and provide the shipping address. Make sure to select 'Yes' or 'No' accordingly.
- In the report type and cost information section, select the report you need: 1 Year Claim Detail Report (CDR), 1 Year Paid Claim Summary Report (PCSR), or 1 Year Ad Hoc Report. Each report has a specified cost, so review this before proceeding.
- Fill out the order information section by entering the relevant CDR/PCSR details. Provide either the NPI number or legacy number, as well as the service date, paid date, and specific claim types. You will also need to fill in the adjudication status for each claim.
- Complete any additional fields required for the order information, ensuring you select the appropriate values for each specified section accurately.
- In the payment information area, note that Xerox will notify you of the total charges after validation. Once your payment is made, select the delivery method that you indicated earlier.
- Finally, review all information for accuracy. Once confirmed, you can save your changes, download the completed form, print it, or share it as needed.
Complete your Xerox CDR & PCSR Request Form online today to ensure timely processing of your requests.
To make multiple copies on a Xerox copier, first set your original document on the glass surface. Use the keypad to enter the number of copies you need. Adjust any other settings as required and press the start button. For official processes, don't forget to utilize the Xerox CDR & PCSR Request Form for effective documentation.
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