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Get Nm Molina Healthcare Checklist & Instructions 2019-2025
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How to use or fill out the NM Molina Healthcare Checklist & Instructions online
Filling out the NM Molina Healthcare Checklist & Instructions is essential for ensuring a smooth credentialing process. This guide offers step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to successfully complete the NM Molina Healthcare Checklist & Instructions.
- Click ‘Get Form’ button to obtain the form and open it in the online editing tool.
- Read the entire checklist thoroughly to understand the requirements and documents needed for submission. Ensure that your CAQH information is current and complete.
- Begin by filling out the Practitioner Information Form. Include your Start/Hire Date, CAQH ID Number (if applicable), Last Name, First Name, Middle Initial, Date of Birth, and the last four digits of your Social Security Number.
- Indicate your Provider Type, Directory Category (PCP, Specialist), and whether you are accepting new members and providing telemedicine services.
- Complete the Primary Practice Information. Indicate whether you operate a solo practice or group/clinic practice, including the practice’s Tax ID number.
- Fill in the Physical Street Address, Suite/Floor, City, State, County, Phone, and Email addresses, ensuring all contact information is up to date.
- Review the forms and ensure that all fields are completed accurately. Missing information can delay the credentialing process.
- Attach any necessary documents as specified in the instructions, ensuring that all forms are signed and dated appropriately.
- Once you have filled out the form and attached all required documents, save your changes. You may also download, print, or share the form as needed.
Complete your NM Molina Healthcare Checklist & Instructions online today to avoid delays in the credentialing process.
Related links form
All of Molina Healthcare, Inc.'s health plan subsidiaries are owned by Molina Healthcare, Inc., a Delaware corporation ( MHI ).
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