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Provider Request for Association With a Billing Agent - Ohio
Provider Request for Association With a Billing Agent is a legal document that was released by the Ohio Department of Developmental Disabilities - a government authority operating within Ohio.
FAQ
Q: What is a Provider Request for Association With a Billing Agent?
A: A Provider Request for Association With a Billing Agent is a form that healthcare providers in Ohio use to request a business relationship with a billing agent.
Q: Why would a healthcare provider need to associate with a billing agent?
A: A healthcare provider may choose to associate with a billing agent to handle the billing and reimbursement processes on their behalf.
Q: What is the purpose of this form?
A: The purpose of this form is to initiate a formal request for association with a billing agent in Ohio.
Form Details:
- Released on March 1, 2018;
- The latest edition currently provided by the Ohio Department of Developmental Disabilities;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Ohio Department of Developmental Disabilities.
