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Beacon Provider Directory Questionnaire free printable template

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Beacon Health Strategies Provider Directory Questionnaire Please provide all of the following information for each location. Attach extra sheets if necessary Date Beacon Provider ID Provider Name Corporation Name Medicare Licensed Medicare Billing FTID Site NPI Please attach a W-9 tax form indicating the practice s legal name and Tax Identification Number Billing Address Billing Phone Site Information please select site number 3 Other Site Address City/State/ZIP Phone Fax Email Address TTY...
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How to fill out Beacon Provider Directory Questionnaire

01
Gather necessary information about your organization and providers.
02
Access the Beacon Provider Directory Questionnaire platform or document.
03
Start by filling out the basic information section, including organization name and contact details.
04
Provide details about the services offered by your organization.
05
List all providers, including their qualifications, specialties, and other relevant credentials.
06
Ensure all necessary documentation is ready to support the information provided.
07
Double-check each section for accuracy and completeness.
08
Submit the completed questionnaire by the specified deadline.

Who needs Beacon Provider Directory Questionnaire?

01
Healthcare providers seeking to be listed in the Beacon Provider Directory.
02
Organizations looking to verify their participation in insurance networks.
03
Providers needing to update their information in the directory.
04
Any entity that wants to ensure compliance with the requirements set by Beacon Health options.
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The Beacon Provider Directory Questionnaire is a tool used to collect information about healthcare providers participating in the Beacon program, aimed at enhancing care coordination and improving accessibility to services.
Healthcare providers who participate in the Beacon program and wish to be listed in the provider directory are required to file the Beacon Provider Directory Questionnaire.
To fill out the Beacon Provider Directory Questionnaire, providers should gather required information about their services, credentials, and operational details, filling in all sections of the questionnaire accurately and completely before submission.
The purpose of the Beacon Provider Directory Questionnaire is to ensure that accurate and up-to-date information about healthcare providers is available to stakeholders, facilitating improved access to care for patients.
The information that must be reported on the Beacon Provider Directory Questionnaire includes provider name, contact information, service specialties, availability, and any relevant credentials and certifications.
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