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US FAMILY HEALTH PLAN ERA CONTRACT INSTRUCTIONS (TH103) Please carefully read all instructions before beginning. FAX or EMAIL all pages of the completed forms with your 2011 W9 to: MD On-Line ATTN:
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How to fill out era enrollment instructions follow:

01
Read the instructions carefully: Start by carefully reading the era enrollment instructions provided. Make sure you understand all the requirements and steps involved in the enrollment process.
02
Gather necessary documents: Before filling out the era enrollment form, gather all the necessary documents that may be required. This may include identification cards, proof of address, or any other relevant documentation.
03
Complete the form accurately: Fill out the era enrollment form accurately and legibly. Make sure to provide all the requested information, double-checking for any errors or missing details.
04
Submit the form: Once you have completed the era enrollment form, follow the instructions provided on how to submit it. This may involve sending it via mail, submitting it online, or delivering it in person.
05
Follow-up if necessary: After submitting the era enrollment form, it is advisable to follow up to ensure that it has been received and processed. Keep track of any confirmation numbers or receipts that may be provided.

Who needs era enrollment instructions follow:

01
Individuals interested in applying for era enrollment: Any individual who wants to enroll in the era program may need to follow the era enrollment instructions. This could include students, professionals, or anyone seeking benefits or participation in the program.
02
Organizations or companies: Sometimes, organizations or companies may also need to follow era enrollment instructions for enrolling in specific programs or benefits offered by the era. These instructions can help them navigate the application process.
03
Individuals assisting others: People who assist others in filling out era enrollment forms, such as family members, social workers, or caregivers, may also need to follow era enrollment instructions to ensure accurate and complete information is provided.
Overall, anyone who is required to complete the era enrollment process or wants to enroll in specific programs or benefits offered under the era may need to follow the era enrollment instructions to ensure a smooth and successful enrollment.
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Era enrollment instructions provide guidance on how to enroll in the Electronic Remittance Advice (ERA) system.
Healthcare providers, billing agencies, and other entities involved in submitting claims may be required to file era enrollment instructions.
Era enrollment instructions can typically be filled out online through the provider portal or by contacting the payer directly.
The purpose of era enrollment instructions is to streamline the payment process by receiving electronic remittance advice instead of paper documents.
Information such as provider name, NPI number, contact information, and bank account details may need to be reported on era enrollment instructions.
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