Complete Provider Disclosure

This page lists the legal information related to the Provider (as completed by the Provider), and allows the Provider to respond to each legal topic/question. This information is used to approve or reject the Provider enrollment.

Note: You must complete all previous steps before you can complete the following procedure.

To complete the provider disclosure:

  1. Select the Step 11: Complete Provider Disclosure hyperlink.

The System displays the Provider Disclosure page.

  1. Select the appropriate Answers to the questions provided and enter any relevant comments.

  2. Select the Save button.

The System saves and updates the Provider Disclosure page.

  1. Select the Close button.

  2. The System displays the Enroll Provider - Special Considerations page.

Related Topics

Special Considerations