Washington IME Provider Renewal Application

State:
Washington
Control #:
WA-SKU-3654
Format:
PDF
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Description

IME Provider Renewal Application Washington IME Provider Renewal Application is a form used by medical providers in Washington State to renew their Independent Medical Examination (IME) provider credential. It is a required form for all IME providers in order to maintain their credential. There are two types of Washington IME Provider Renewal Applications: a renewal and a re-enrollment application. The renewal application is used by providers who are already registered as an IME provider and need to renew their credential every two years. The re-enrollment application is used by providers who are looking to become an IME provider for the first time. Both applications require the same information, including the provider's name, contact information, type of credential they are applying for, and the name of the insurance company. After submitting the application, the provider will receive a confirmation of their renewal or re-enrollment.

Washington IME Provider Renewal Application is a form used by medical providers in Washington State to renew their Independent Medical Examination (IME) provider credential. It is a required form for all IME providers in order to maintain their credential. There are two types of Washington IME Provider Renewal Applications: a renewal and a re-enrollment application. The renewal application is used by providers who are already registered as an IME provider and need to renew their credential every two years. The re-enrollment application is used by providers who are looking to become an IME provider for the first time. Both applications require the same information, including the provider's name, contact information, type of credential they are applying for, and the name of the insurance company. After submitting the application, the provider will receive a confirmation of their renewal or re-enrollment.

How to fill out Washington IME Provider Renewal Application?

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Washington IME Provider Renewal Application