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Payer ID: 56196First Carolina Care 835 EDI Enrollment Instructions: To authorize this payer to provide ERA to your clearinghouse, via Change Healthcare, complete the following form. Please save this

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How to fill out provider quick reference user

01

Gather all necessary information about the provider you are referencing

02

Open the provider quick reference user form

03

Fill in the provider's name, contact information, and any other required details

04

Double-check the information for accuracy and completeness

05

Save or submit the completed form as needed

Who needs provider quick reference user?

01

Healthcare professionals who need a quick and easy way to access essential information about a specific healthcare provider

02

Administrative staff who need to keep track of provider details for scheduling, billing, and other purposes

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What is provider quick reference user?

Provider quick reference user is a simplified form used to report essential information about a provider.

Who is required to file provider quick reference user?

Any entity or individual who provides services and wants to receive payment from the payer is required to file the provider quick reference user.

How to fill out provider quick reference user?

The provider quick reference user can be filled out electronically or manually by providing basic information such as provider name, contact information, and services offered.

What is the purpose of provider quick reference user?

The purpose of the provider quick reference user is to streamline the payment process by providing necessary information about the provider to the payer.

What information must be reported on provider quick reference user?

The provider quick reference user must include provider name, contact information, services provided, payment details, and any other relevant information.

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