Download W-9 Form
Download a standard W-9 Form.
(Standard Precert Form). This form is for use in the precertification of plan services as defined by the plan document.
- Note: Always check the plan member’s ID Card. Plans using certain provider networks require precertification to be obtained through their precertification department.
Claim Submission Instructions
(Providers will receive these instructions when they request a faxback verification. This information will compliment the instructions for claim submission on the participant’s ID Card, which includes the electronic submission payor id number.
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