Get Ncdoi Application

Filling out the Ncdoi application is a crucial step for health care practitioners seeking to participate in health benefit plans. This guide will provide you with a comprehensive, user-friendly approach to completing the application online efficiently and accurately.

Follow the steps to complete your Ncdoi application with ease.

1. Click ‘Get Form’ button to access the Ncdoi application. This step will allow you to open the form in the online editor.
2. Begin filling out the 'Demographic and Personal Data' section. Enter your full name as it appears on your legal documents, date and place of birth, and social security number. Make sure to specify your gender and the type of practice you are engaged in, whether primary care or specialist.
3. Provide information about your practice. Include the name and address of your primary office, ensuring to note whether it is handicap accessible. Also, indicate if you are accepting new patients and include your office hours along with contact information such as phone and fax numbers.
4. If applicable, complete details for any secondary offices, including similar information on accessibility, patient acceptance, and contact details.
5. Continue to the licensing and certification section. Report any licenses, including your federal tax ID number, DEA number, and any applicable specialty board certifications.
6. Fill out the 'Education and Practice History' section. List your relevant educational background, internships, residencies, and work history, providing specific dates and details about each institution and role.
7. Address any professional information queries. Respond clearly to questions regarding your license status, any disciplinary actions, and professional liability claims to the best of your knowledge.
8. Complete the supplemental forms if you answer 'yes' to any professional liability questions. Provide thorough explanations and necessary documentation.
9. Finalize your application by signing the attestation statement, certifying that all information provided is true and accurate. Ensure to follow the instructions regarding the submission of original documents.
10. Once completed, save your changes, and download or print the Ncdoi application for your records. You may also choose to share it with relevant organizations if necessary.

Start your Ncdoi application today and complete the process online for a smoother experience.