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SEC Form 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSIONER 4Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIPCheck this box if no longer subject to Section 16. Form 4 or Form 5
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How to fill out regence prefix list form
How to fill out regence prefix list form
01
To fill out the Regence prefix list form, follow these steps:
02
Obtain a copy of the form from the official Regence website or request it from a Regence representative.
03
Read the instructions provided on the form to understand the information required.
04
Gather the necessary information, such as the medical provider's name, contact information, and requested prefixes.
05
Fill out the form accurately and legibly, providing all required information and double-checking for any errors.
06
Submit the completed form to the designated address or submit it electronically as instructed.
07
Keep a copy of the filled-out form and any supporting documentation for your records.
08
Wait for a confirmation or response from Regence regarding the status of your request.
09
If any further action is required, follow the instructions provided by Regence.
10
Keep a record of any correspondence or communication related to the Regence prefix list form.
Who needs regence prefix list form?
01
Anyone who is a medical provider or organization looking to participate or be recognized by Regence might need to fill out the Regence prefix list form.
02
This form is typically required for providers who want to submit claims or receive payments from Regence insurance plans.
03
It ensures that the correct prefixes are used for identification purposes and helps streamline the claims process.
04
Specifically, healthcare providers such as doctors, hospitals, clinics, and other healthcare facilities may need to complete this form.
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What is regence prefix list form?
The Regence prefix list form is a document used by healthcare providers to report specific prefix codes assigned to insurance plans.
Who is required to file regence prefix list form?
Healthcare providers and organizations that are participating in plans offered by Regence are required to file the regence prefix list form.
How to fill out regence prefix list form?
To fill out the regence prefix list form, provide accurate prefix codes, the corresponding plan names, and additional required information as specified in the form instructions.
What is the purpose of regence prefix list form?
The purpose of the regence prefix list form is to ensure that healthcare providers have the correct prefix codes for billing and claims processing related to Regence health plans.
What information must be reported on regence prefix list form?
The information that must be reported includes prefix codes, associated plan names, and relevant provider information.
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