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Existing Provider Migration FormOrganization Name:___Address:___ ___ ___ ___Phone:___Primary Contact:___Administrators Name:___Administrators Email:___iCodeConnect Username: ___ Physicians to add
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Obtain a copy of the existing provider migration form.
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Submit the completed form to the appropriate department or person as instructed.

Who needs existing provider migration form?

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Individuals or organizations looking to migrate from one service provider to another.
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The existing provider migration form is a document that allows current service providers to formally transition to a new regulatory or compliance framework as mandated by specific regulations.
All current service providers who are affected by the new regulatory changes and wish to continue their services under the new framework are required to file the existing provider migration form.
To fill out the existing provider migration form, providers must provide their current service details, compliance information, and any additional documentation required by the governing body overseeing the migration process.
The purpose of the existing provider migration form is to ensure that service providers comply with new regulations and standards, facilitating a smooth transition while maintaining oversight and service continuity.
The information that must be reported includes the provider’s current registration details, service categories, changes in service delivery models, and any certifications or compliance status updates.
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