Fillable sc medicaid trading partner agreement enrollment form

Description
Trading Partner Agreement Enrollment Instructions for Providers The Trading Partner Agreement Enrollment (TPA) form may be found online at http://www.dhhs.state.sc.us/dhhsnew/hipaa/webfiles/TradingPartnerEnrollmentForm.pdf Please use the instructions below to fill out the TPA. Incomplete or incorrect TPAs will not be processed. FIELD Date Action Requested Trading Partner Name INSTRUCTIONS Enter today's date. Leave...
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