Get the free BHP New Provider Enrollment Form

Name: Fillable Online BHP New Provider Enrollment Form Fax Email Print - pdfFiller
Brand: pdfFiller
Rating: 4.2 (52 reviews)

Get Form

Show details

Com Or use the submit button at the bottom of this page. Buckeye Health Plan requires all providers to utilize CAQH for credentialing. Date Completing How many locations does the provider work at under this tin Contact Information Credentialing Contact Group Information Group Name Group NPI Group Tax ID Number Billing Office Address State Zip Provider Information Provider First Name Middle Name Last Name Provider DOB Provider SSN OH Medicaid Number DEA Number State License Number Licensed...

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign bhp new provider enrollment

Edit your bhp new provider enrollment form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your bhp new provider enrollment form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit bhp new provider enrollment online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

To use the services of a skilled PDF editor, follow these steps:

1

Set up an account. If you are a new user, click Start Free Trial and establish a profile.

2

Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.

3

Edit bhp new provider enrollment. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.

4

Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.

It's easier to work with documents with pdfFiller than you could have ever thought. You may try it out for yourself by signing up for an account.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out bhp new provider enrollment

01

Step 1: Visit the BHP website

02

Step 2: Navigate to the 'Provider Enrollment' section

03

Step 3: Click on 'New Provider Enrollment'

04

Step 4: Fill out all the required fields accurately

05

Step 5: Upload any necessary supporting documents

06

Step 6: Review the information provided

07

Step 7: Submit the enrollment application

08

Step 8: Wait for a response from BHP regarding your application

09

Step 9: Follow any additional instructions provided by BHP

10

Step 10: Once approved, you can start providing services under BHP

Who needs bhp new provider enrollment?

01

Healthcare providers who wish to participate in the BHP network

02

New providers who have never enrolled in BHP before

03

Providers seeking to expand their services to BHP beneficiaries

04

Providers whose current enrollment has expired and need to reapply

05

Providers who have made significant changes to their practice and need to update their enrollment

Fill form : Try Risk Free

Rate the form

4.2

Satisfied

52 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

How do I fill out the bhp new provider enrollment form on my smartphone?

Use the pdfFiller mobile app to complete and sign bhp new provider enrollment on your mobile device. Visit our web page (https://edit-pdf-ios-android.pdffiller.com/) to learn more about our mobile applications, the capabilities you’ll have access to, and the steps to take to get up and running.

Can I edit bhp new provider enrollment on an iOS device?

Create, modify, and share bhp new provider enrollment using the pdfFiller iOS app. Easy to install from the Apple Store. You may sign up for a free trial and then purchase a membership.

How can I fill out bhp new provider enrollment on an iOS device?

Install the pdfFiller app on your iOS device to fill out papers. Create an account or log in if you already have one. After registering, upload your bhp new provider enrollment. You may now use pdfFiller's advanced features like adding fillable fields and eSigning documents from any device, anywhere.

What is bhp new provider enrollment?

BHP new provider enrollment is the process of submitting an application to become a new provider with a Behavioral Health Provider (BHP) network.

Who is required to file bhp new provider enrollment?

Any healthcare provider or organization looking to join the BHP network is required to file a new provider enrollment application.

How to fill out bhp new provider enrollment?

To fill out the BHP new provider enrollment, providers need to complete the application form with accurate information and submit all required documentation.

What is the purpose of bhp new provider enrollment?

The purpose of BHP new provider enrollment is to expand the network of healthcare providers available to serve patients covered under BHP plans.

What information must be reported on bhp new provider enrollment?

Providers must report their contact information, credentials, services offered, billing information, and other relevant details on the BHP new provider enrollment application.

Fill out your bhp new provider enrollment online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now