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FOR HSA USE ONLY SUB ID NO.:___ EFF. DATE:___ GROUP NO.:___ CONT.:___ PKG.:___ APP REV DATE:___ PRO. DATE:___ NOTES: ___ ___INDIVIDUAL PLAN APPLICATION REP Name and ID#:___A. Subscriber Information:

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What is prchmsacomsprovider resource center?

The prchmsacomsprovider resource center is a platform for providers to submit information related to services provided under the PRCHMSA program.

Who is required to file prchmsacomsprovider resource center?

All providers participating in the PRCHMSA program are required to file the resource center.

How to fill out prchmsacomsprovider resource center?

Providers can fill out the resource center online by logging into their account and entering the required information.

What is the purpose of prchmsacomsprovider resource center?

The purpose of the resource center is to track and report on the services provided under the PRCHMSA program.

What information must be reported on prchmsacomsprovider resource center?

Providers must report on the services provided, patient demographics, and any outcome measures specified by the program.

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