Get Ihocs Specialty Network Questionnaire And Contact List 2019-2025

Completing the IHOCs Specialty Network Questionnaire and Contact List is essential for proper documentation and compliance with payer requirements. This guide provides clear and precise instructions for filling out the form online.

Follow the steps to fill out the questionnaire and contact list effectively.

1. Press the ‘Get Form’ button to access the document and open it in an online editor.
2. Begin with the questionnaire section. Fill in your business website, select the entity type from the dropdown, and indicate the state of formation. Ensure all entries are accurate and up-to-date.
3. In the pharmacy dispensing system section, provide the necessary details about your pharmacy software vendor name and electronic health record software vendor name. Double-check spelling and formatting for clarity.
4. Move to the contact list section. You must include information for a pharmacist in charge, chief pharmacy officer, specialty director or manager, and reimbursement officer. Start by filling the required fields for Contact 1.
5. For each contact entry, input the first and last name, select their title from the options provided, add their email address, and provide a phone number. Enter the state board of pharmacy license number, select the license state, and indicate the expiration date.
6. Continue filling out details for Contacts 2 through 5, ensuring all required fields are filled in accurately. If additional contacts are not necessary, you may leave the remaining entry fields blank.
7. Once all sections are completed, review the entered information thoroughly to ensure accuracy. Make any necessary corrections before finalizing.
8. After reviewing, you have the option to save your changes, download the completed form, print it, or share it with necessary stakeholders.

Take the next step to complete your IHOCs Specialty Network Questionnaire and Contact List online today.