Get Healthyroads Biometrics Screening Results - Health Care Provider Form 2014-2025

This guide provides comprehensive instructions on how to complete the Healthyroads Biometrics Screening Results - Health Care Provider Form online. Following these steps will help ensure your submission is accurate and processed efficiently.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to obtain the form and open it in your chosen online editor.
2. Carefully fill in your personal information in Part I, including your first name, last name, date of birth, and other relevant details. Ensure all required fields, marked with an asterisk (*), are fully completed.
3. Provide your contact information, including phone number and email address, ensuring accuracy for potential follow-ups.
4. Review the Member Attestation/Authorization section. It is crucial to read and understand this section before signing, as it authorizes your Health Care Provider to report your screening results.
5. Instruct your Health Care Provider to complete Part II of the form after your biometric screening visit, ensuring they sign and date the form.
6. Double-check all entries for legibility and completeness. Remember that incomplete forms will not be processed.
7. Once all fields are filled, save your changes. You may then download or print the form for your records or send it directly to Healthyroads.
8. Submit the completed form via the specified methods: fax, secure email, or mail, ensuring it is sent before the deadline.

Act now to complete your Healthyroads Biometrics Screening Results - Health Care Provider Form online and ensure you receive your incentive credit.