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Get Caresource Cs-0208c 2016-2025
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How to fill out the CareSource CS-0208c online
The CareSource CS-0208c is an essential form used for making changes regarding providers within a participating group. This guide will walk you through the process of completing the form online, ensuring accuracy and efficiency.
Follow the steps to complete the CareSource CS-0208c effectively.
- Press the ‘Get Form’ button to acquire the form and open it in your preferred editor.
- Begin by filling out the date at the top of the form as this provides a reference for when the request is made.
- Indicate the PR Representative responsible for the changes by entering their name in the designated field.
- Choose the type of change you are requesting: adding a provider, deleting a provider, or changing provider demographics.
- In the Group Information section, enter the IRS Name, DBA Name, TIN, NPI, and the relevant Medicare and Medicaid numbers.
- Select the applicable product from the options listed, including MyCare-OH, Medicaid-WV, Just4Me-OH, and others.
- Provide the contact information for your office including the contact name, phone number, and email address.
- Indicate the type of organization by checking the appropriate box (e.g., FQHC, RHC).
- Fill in the Contract Signatory details, ensuring to include the name, title, email, and address.
- In the Provider Information section, enter details for the provider being added or modified, including their name, degree, address, phone, NPI number, and any relevant specialty.
- For racial and ethnic breakdowns, choose the appropriate categories as they relate to the provider.
- Provide any additional notes necessary for the changes in the dedicated Notes section.
- Ensure to include a W-9 and verify that all CAQH applications are current to facilitate timely processing.
- Once all fields are accurately filled, save the changes to your document, and you can choose to download, print, or share the completed form.
Complete your CareSource CS-0208c form online today to ensure efficient processing of your request.
Related links form
CareSource CS-0208c through Medicaid is designed for low-income individuals, while CareSource marketplace plans are for those who do not qualify for Medicaid but still seek affordable coverage. The key difference lies in eligibility and the types of financial assistance available. Both options provide comprehensive healthcare services, but target different user needs.
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