Get the free Provider Information 09-10 - rccservices

Provider Information July 2009 16300 First Street / PO Box 16 Greenville CA 95446 707 869 3613 707 869 2616 fax www.rccservices.org 1 Revised June 2009 Provider Information Welcome .....................................................................................3

How to fill out provider information 09-10

How to fill out provider information 09-10:

1. Start by retrieving the provider information form labeled "09-10."
2. Carefully read the instructions provided on the form to understand the required information.
3. Begin by entering the provider's name in the designated field. Make sure to include all relevant information such as first name, last name, and any applicable suffixes.
4. Move on to filling out the contact information section. Include the provider's phone number, email address, and mailing address. Double-check for accuracy to ensure that any future correspondence reaches the provider successfully.
5. Next, provide the provider's specialty or area of expertise. This could include details such as primary care, dermatology, cardiology, etc.
6. If applicable, specify the provider's sub-specialty or any additional certifications they may possess.
7. Enter the provider's NPI (National Provider Identifier) number. This unique 10-digit identifier ensures proper identification of healthcare providers.
8. Provide the Tax Identification Number (TIN) for the provider or their organization. This helps with financial record-keeping purposes.
9. If necessary, fill out any additional fields related to the provider's billing or enrollment status.
10. Review the completed form for any errors or omissions. Ensure that all information is accurate and up-to-date.
11. Sign and date the form as required. This verifies the authenticity and authorization of the information provided.

Who needs provider information 09-10?

1. Various entities within the healthcare industry, such as insurance companies, government agencies, and medical facilities, require provider information 09-10.
2. Insurance companies need this information to accurately process claims, verify provider credentials, and maintain their provider directories.
3. Government agencies, such as Medicaid or Medicare, may require provider information 09-10 for enrollment purposes or to ensure compliance with regulations.
4. Medical facilities, including hospitals, clinics, and private practices, utilize this information to maintain accurate records, coordinate patient care, and facilitate communication with healthcare providers.
5. Patients may also benefit from having access to provider information 09-10. It allows them to make informed decisions when choosing a healthcare provider, understanding their specialties, and verifying their credentials.

For pdfFiller’s FAQs

What is provider information 09-10?

Provider information 09-10 refers to the specific details and data required to be reported by providers for a certain period of time.

Who is required to file provider information 09-10?

All providers who meet the criteria set by the regulatory body are required to file provider information 09-10.

How to fill out provider information 09-10?

Providers can fill out the information required for provider information 09-10 through an online portal or by submitting a physical form.

What is the purpose of provider information 09-10?

The purpose of provider information 09-10 is to ensure transparency and accountability in the provider sector, and to track and monitor the activities of providers.

What information must be reported on provider information 09-10?

Providers must report details such as their contact information, services provided, financial information, and any other relevant data specified by the regulatory body.

How can I send provider information 09-10 for eSignature?

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