MI McLaren Health Plan Provider Information Form 2015 free printable template

PROVIDER INFORMATION FORM Please complete this form to ensure accurate provider directory and payment information. If needed, copy this form for additional sites. Group Name (or Name of Practice):Fed

How to fill out MI McLaren Health Plan Provider Information

How to fill out MI McLaren Health Plan Provider Information Form

1. Obtain the MI McLaren Health Plan Provider Information Form from the official McLaren Health website or request from your local McLaren health office.
2. Fill in the provider's name, address, and contact information in the designated fields.
3. Provide the National Provider Identifier (NPI) number and any relevant licensing information.
4. Include details about the provider's specialty and any relevant certifications.
5. Indicate billing information and any associated tax identification numbers (TIN).
6. Review the completed form for accuracy and completeness.
7. Sign and date the form where indicated.
8. Submit the completed form via email, fax, or mail as per the instructions provided on the form.

Who needs MI McLaren Health Plan Provider Information Form?

1. Healthcare providers who wish to participate in the McLaren Health Plan network.
2. New providers applying for credentialing with McLaren Health Plan.
3. Existing providers updating their information with McLaren Health Plan.

People Also Ask about

What is the Healthy Michigan plan?

The Healthy Michigan Plan is a managed care health plan contracted with the state of Michigan. Blue Cross Complete of Michigan administers Healthy Michigan Plan benefits to eligible members.

What is the phone number for McLaren Healthy Michigan Group?

For questions regarding policy and coverage information, call: 1-888-327-0671.

Is McLaren HMP Medicaid?

With McLaren Health Plan Medicaid, you get doctor visits, prescription drugs, well visits, children's health services and much more. Free transportation is offered to and from medical visits. Eligibility is determined by local Department of Human Services (DHS) offices.

What is the payer ID for McLaren health plan?

McLaren Health Advantage's EDI payer ID is 38338. Contracted providers are paid ing to the McLaren Health Advantage fee schedule.

What is the phone number for McLaren Oakland Hospital billing?

Please direct billing questions to: Patient Accounting 989-894-8888 or 888-899-1077. Office hours are Monday - Friday 8 a.m. - 4 p.m.

What is the payer ID for McLaren Health Plan Medicaid?

McLaren Health Advantage's EDI payer ID is 38338. Contracted providers are paid ing to the McLaren Health Advantage fee schedule.

Is Healthy Michigan plan Medicaid or Medicare?

The Healthy Michigan Plan is a Medicaid health care program through the Michigan Department of Health and Human Services (MDHHS).

What's the difference between Medicaid and Healthy Michigan plan?

The Healthy Michigan Plan is a type of Medicaid coverage. Medicaid is a partnership between federal and state governments. They work together to provide coverage. The federal government gives rules and resources.

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What is MI McLaren Health Plan Provider Information Form?

The MI McLaren Health Plan Provider Information Form is a document used by healthcare providers to submit key information to the McLaren Health Plan, ensuring compliance and facilitating the coordination of care for patients.

Who is required to file MI McLaren Health Plan Provider Information Form?

Healthcare providers who wish to participate in the McLaren Health Plan network or who are providing services to McLaren members are required to file this form.

How to fill out MI McLaren Health Plan Provider Information Form?

To fill out the MI McLaren Health Plan Provider Information Form, providers need to gather necessary details such as their practice information, NPI number, contact information, and identifying details about their services and specialties, and then accurately complete each section of the form before submission.

What is the purpose of MI McLaren Health Plan Provider Information Form?

The purpose of the MI McLaren Health Plan Provider Information Form is to collect essential data from providers for credentialing, to streamline network participation, enhance patient care coordination, and maintain accurate provider directories.

What information must be reported on MI McLaren Health Plan Provider Information Form?

The information that must be reported on the MI McLaren Health Plan Provider Information Form includes the provider's name, practice location, NPI number, specialties, contact information, and any other relevant details that pertain to the provider's qualifications and services offered.