fax and ehrs form

Description
Incentive Voucher In addition to the application, practices must submit an EHR Monetary Incentive Voucher (voucher) to the appropriate payor(s) to request the incentive payment. Payors may request additional information to validate the voucher request. The voucher will include: Copy of the payor's application acknowledgement letter; and Report listing the members of the practice at the time of request; or In cases...
Fill & Sign Online, Print, Email, Fax, or Download
Fill Online
  • Fill Online
  • eSign
  • eFax
  • Email
  • Add Annotations
  • Share
fax and ehrs
Rate This Form

4.9

Satisfied

50

 Votes