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P.O. Box 1827 York, PA 17405 18006732514 Toll Free 7178514493 Fax www.WellSpan.org/EAPWellSpan EAP Referral and Invoice Date of Intake: Completed By: Referred To:Affiliate Contacted: Forms Faxed:
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How to fill out wellspan eap new provider
How to fill out wellspan eap new provider
01
Obtain the wellspan eap new provider form from the appropriate source.
02
Fill in all required personal information such as name, address, contact details, etc.
03
Provide information about your credentials, specialties, and experience as a healthcare provider.
04
Submit any required supporting documents such as proof of licensure, insurance, and certifications.
05
Review the form for accuracy and completeness before submitting it to wellspan eap.
Who needs wellspan eap new provider?
01
Healthcare providers who wish to join the wellspan eap network and provide services to clients covered by the program.
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What is wellspan eap new provider?
WellSpan EAP New Provider is a platform that allows new providers to join the WellSpan Employee Assistance Program network.
Who is required to file wellspan eap new provider?
New providers who wish to join the WellSpan Employee Assistance Program network are required to file the WellSpan EAP New Provider form.
How to fill out wellspan eap new provider?
To fill out the WellSpan EAP New Provider form, providers need to provide their relevant information such as contact details, services offered, credentials, and more.
What is the purpose of wellspan eap new provider?
The purpose of WellSpan EAP New Provider is to expand the network of providers available to WellSpan's Employee Assistance Program, ensuring employees have access to a wide range of services.
What information must be reported on wellspan eap new provider?
Providers must report their contact information, services offered, credentials, availability, and any other relevant details to be considered for joining the WellSpan EAP network.
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