UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum 2011-2025 free printable template
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FMO Relationship Hierarchy Addendum THIS IS A WRITABLE FORM* Please type in the information below. Use the Tab key to move through the fields Please complete and attach this page for all producer
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How to fill out UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum
01
Begin by downloading the UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum form from the official website.
02
Carefully read the instructions provided on the first page of the form.
03
Enter your organization’s name, address, and contact details in the designated fields.
04
Identify and list all FMOs (Field Marketing Organizations) with whom you have a relationship.
05
For each FMO listed, provide their National Producer Number (NPN) and any other relevant identification details.
06
Specify the nature of the relationship you have with each FMO, such as contractual agreements.
07
Review your entries for accuracy and completeness.
08
Sign and date the form where indicated.
09
Submit the completed form as per the outlined submission guidelines.
Who needs UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum?
01
Any organization or individual that partners with UnitedHealthcare to market and sell Medicare solutions.
02
Field Marketing Organizations (FMOs) that need to document their relationships with UnitedHealthcare.
03
Agents or brokers who are affiliated with multiple FMOs and require the addendum for compliance.
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What is UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum?
The UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum is a document that provides a structured outline of the relationships between different agents, agencies, and their affiliations in the Medicare Solutions market.
Who is required to file UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum?
FMOs (Field Marketing Organizations) and any entities or agents that are involved in the marketing and distribution of UnitedHealthcare Medicare Solutions products are required to file the addendum.
How to fill out UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum?
To fill out the addendum, individuals must provide detailed information about their organization, including the names of agents, operational structures, and their respective relationships, making sure to follow the prescribed format and guidelines provided by UnitedHealthcare.
What is the purpose of UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum?
The purpose of the addendum is to ensure transparency in the relationships within the distribution network, allowing UnitedHealthcare to maintain compliance with regulatory requirements and to facilitate better communication among stakeholders.
What information must be reported on UnitedHealthcare Medicare Solutions FMO Relationship Hierarchy Addendum?
The information that must be reported includes the names of all related organizations, the hierarchy of those organizations, details on agents and agencies, the type of relationships (e.g., appointment levels), and any other relevant data outlined in the filing instructions.
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