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  • Meridian Form 30 2013

Get Meridian Form 30 2013-2025

Set up with central pay. The central pay PSAO is eligible to receive EFT. If you are an affiliate of a PSAO utilizing central pay and would like to change your payment to EFT, you will need to contact your PSAO directly. PART I: REASON FOR SUBMISSION New EFT Authorization Cancel EFT Revision to Existing Enrollment (e.g. account or bank changes) Enroll in Electronic Remittance Advice (ERA) to Receive 835 Transmissions PART II: PHARMACY/ORGANIZATION INFORMATION Tax ID: Chain C.

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Please call Meridian Provider Services at 866-606-3700.

Call the DHS Customer Service Helpline for assistance at: (800) 843-6154 voice/(866) 324-5553 TTY, Monday through Friday, 8:00 a.m. to 5:30 p.m., except state holidays. Where can I find official DHS forms?

We're here to help. Just call Meridian Member Services at 866-606-3700 (TTY: 711).

If you aren't sure if your Medicaid coverage has been approved yet or if it is still active, you can check Manage My Case or call the state's Automated Voice Recognition System (AVRS) at 1-855-828-4995 with your Recipient Identification Number (RIN).

The Meridian Medicaid Plan is a Medicaid managed care health plan in Illinois. We connect Medicaid beneficiaries to the care that they need. Our plan is part of HealthChoice Illinois.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232