Add Servicing Provider Information
Use this link to add each Provider who will be providing services to the Claimants under the Provider group. This information is used to adjudicate bills.
Note: You must complete all previous steps before you can complete the following procedure.
To add the Servicing Provider information
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Select the Step 10: Add Servicing Provider Information hyperlink.
The System displays the Servicing Providers page.
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Select the Add button
The System displays the Associate Servicing Provider page.
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Select a Tax Identifier Type.
Note: The Tax Identifier Type that you select may change which fields are required.
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Select a Provider Type.
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Enter the required (*) information based on your previous selection.
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Enter the Licensing/Certification information.
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Select the OK button.
The System saves the Servicing Provider information and displays the Servicing Providers page.
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Select the Close button.
The System displays the Enroll Provider -Group Practice page.