Provider Relations - Michigan

REAL ESTATE INDIVIDUAL OR ASSOCIATE BROKER …

2 of 3 New Employing Broker Name (This does not apply to Individual Broker applicants.) Employing Broker Permanent I.D. Number (if applicable)

  Individuals

Test Requisition - State of Michigan …

STATE OF MICHIGAN - LABORATORY TEST REQUISITION Microbiology / Virology DCH - 0583 May 17, 2018 By Authority of Act 368, P.A. 1978 AGENCY CODE (If Known)

  Microbiology

State of Michigan Voter Registration Application

State of Michigan Voter Registration Application and Michigan Driver License/Personal Identification Card Address Change Form Instructions Track your registration status, find your local clerk, view your polling location, and more at mi.gov/vote.

  Applications

APPLICATION FOR A CERTIFIED COPY — MICHIGAN …

PART 6 -FEES Includes one certified copy or no-find letter PART 5 -INFORMATION NEEDED TO FIND BIRTH RECORD BEING REQUESTED APPLICATION FOR A CERTIFIED COPY — MICHIGAN BIRTH RECORD

  Birth

2017-2018 STATE SCHOOL AID INFORMATION …

2017-2018 STATE SCHOOL AID INFORMATION DIRECTORY . NOTE: See “Field Services” description on page 8.. Section 3(4) - “Cooperative Education Program” definition

  Information, States

Application for Michigan Notary Public Commission

michigan department of state office of the great seal form 98 (rev. 12/14) application for michigan notary public commission

  Applications, Commission, Public, Notary, Notary public commission

Handbook for Military Retirees - michigan.gov

1 department of military and veterans affairs michigan army and air national guard handbook for retirees (information and benefits upon retirement)

  Handbook, Michigan

Law Enforcement Division Bi-Weekly Field Report

Law Enforcement Division Bi-Weekly Field Report 12/3/2017 – 12/16/2017 DISTRICT 1 Conservation Officer (CO) Ethen Mapes responded to a call involving a snowmobiler

ichigan cia ro

Michigan grows a wide variety of specialty crops each year, and our farmers take pride in growing high quality, diverse products. The state leads the

  Corps

GENERAL INFORMATION ABOUT TRAUMA AND …

National Council for Community Behavioral Health Care, “How to Manage Trauma” User friendly infographic explaining trauma, its impact and coping strategies.

National Uniform Claim Committee

Facility) 2310D (Supervising) 2300 NTE 2300 PWK 2310A REF01 ... HI11-2, HI12-2 22 2300 in the 837P Resubmission and/or Original Reference Number 2300 CLM05-3 Titled Claim Frequency Code in the 837P. REF02 Titled Payer Claim Control Number. 23 2300 2300 ... Rendering Provider ID # 2310B PRV03 REF02 Titled Provider Taxonomy Code and …

  Reference, Facility, Provider, Number, Payer, Reference number, Provider id

BEHAVIORAL QUICK REFERENCE GUIDE - Cigna

Provider reference guide for benefit administration . BEHAVIORAL ... fax number, and payer ID . Standard PPO Cigna Healthcare PO Box 182223, Chattanooga, TN 37422 Fax: 859.410.2422 ... For information about individual, clinical, and facility applications, visit . …

  Guide, Reference, Facility, Provider, Number, Cigna, Payer, Reference guide, Provider reference guide, Payer id

Payer ID provider number reference — Facility

Payer ID provider number reference — Facility Rev. January 2022 2 Payer information Prefix Product name for electronic claims Emdeon payer information* Paper claim mailing address Billing provider ISA-08 GS-03 Personal Choice® (continued) Independence Valid and registered NPIReserve, is required. Electronic (837I) Loop 2010AA NM108 = XX

  Reference, Facility, Provider, Number, Payer, Payer id provider number reference facility

Medi-Cal Rx NCPDP Payer Specification Sheet

Payer Situation 202-B2 Service Provider ID Qualifier 01 = National Provider Identifier (NPI) M 201-B1 Service Provider ID M 401-D1 Date of Service M 110-AK Software Vendor/ Certification ID This will be provided by the provider’s software vendor. ... Reference Number Qualifier 1= Rx Billing M 402-D2 Prescription/Service Reference Number

  Reference, Provider, Number, Payer, Reference number, Provider id

OptumRx NCPDP Version D.0 Payer Sheet COMMERCIAL AND …

payer situation 466-ez prescriber id qualifier m 411-db prescriber id m npi should be submitted whenever possible 427-dr prescriber last name o 498-pm prescriber phone number o 468-2e primary care provider id qualifier o 421-dl primary care provider id o 47Ø-4e primary care provider last name o

  Provider, Number, Payer, Provider id

Billing and Claims Quick Reference Guide 4 - Aetna

Oct 01, 2018 · • To enroll or validate PROMISe ID’s use the attached link: https://provider.enrollment.dpw.state.pa.us/ • MA & CHIP Providers must have a valid PROMISe Identification Number (PROMISe ID) for every service location where they practice • DHS uses the NPI and taxonomy submitted on claims to validate the enrollment of providers in PROMISe

  Reference, Aetna, Provider, Number

Independence Blue Cross Quick Reference Guide

Provider inquiries • Call the general 800 number listed in this Quick Reference Guide for claims and authorization questions. • Call the Magellan national Provider Services Line at 1-800-788-4005 for general inquiries, including credentialing and network status.

  Cross, Reference, Provider, Blue, Number, Independence, Independence blue cross

Aetna Signature Administrators solution

provider organization (PPO) plans. We’ve established relationships with a limited number of payers. These payers include leading third-party administrators and carriers. y meet our standard requirements and agree to follow our policies and procedures. The Aetna Signature Administrators solution is another way we offer our PPO product.

  Aetna, Provider, Number, Administrator, Signature, Aetna signature administrators