Get Tx Group Provider Record Id Information Form Packet 2018-2025
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the TX Group Provider Record ID Information Form Packet online
Filling out the TX Group Provider Record ID Information Form Packet online can streamline the process of obtaining your organization's Group Provider Record ID. This guide provides clear and supportive instructions to help you complete each section accurately and efficiently.
Follow the steps to complete the form online.
- Press the ‘Get Form’ button to access the TX Group Provider Record ID Information Form Packet and open it in your chosen editor.
- Begin with the 'Provider of Service Information' section. Enter the practice address, including suite number, city, state, zip code, phone number, and fax number. For the group or company name, ensure it matches the name shown on the W-9 form.
- In the 'Specialty or Type of Group/Company' field, select only one specialty that best represents the majority of your organization's practice.
- Complete the 'Billing Information' section by filling in the Tax Identification Number (TIN) or Employer Identification Number (EIN). This form requires a response to whether this number is your personal taxpayer number or belongs to a corporation.
- Provide the contact name and accounting address where payments should be mailed. Ensure this address includes all relevant details, such as suite number, city, state, and zip code.
- State that to the best of your knowledge, the information supplied is accurate and complete. This declaration must be executed by an authorized representative of the organization.
- Include the mandatory attachments, specifically the completed W-9 form and the state license for each provider.
- Review all information for completeness and accuracy. Submit the completed application to Blue Cross and Blue Shield of Texas via fax or mail as indicated in the instructions.
- After submission, ensure you keep a copy of the completed forms for your records. Monitor for any notifications from BCBSTX regarding the processing of your Group Provider Record ID.
Start completing your forms online today to ensure your organization's registration is processed smoothly.
Related links form
BCBS of Texas customer service hours can vary based on the day and specific department. Typically, they operate during standard business hours, which are Monday through Friday. To confirm if they are open today, you can check their official website or contact their customer service directly, especially if you need assistance with your TX Group Provider Record ID Information Form Packet.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.