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PAYER ID: 12001SUBMITTER ID:103626Change Healthcare CLAIM Provider Information Form *This form is to ensure accuracy in updating the appropriate account1Provider OrganizationPractice/ Facility NameProvider
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Payer ID 12001 is a unique identifier assigned to a specific payer for reporting purposes.
Any entity that makes payments to others and is required to report those payments to the IRS must file payer ID 12001.
Payer ID 12001 should be filled out with accurate information about the payer, recipient, and payment details, following the IRS guidelines for reporting.
The purpose of payer ID 12001 is to track and report payments made by a specific payer to recipients for tax reporting purposes.
Information such as the payer's name, address, TIN, recipient's name, address, TIN, payment amount, and payment date must be reported on payer ID 12001.
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