NOTE: A provider may have multiple provider accounts if the provider bills for services using multiple Tax ID numbers.
Use this tutorial to enter or update detailed information about a provider's account on the Provider Account Detail for Payee page.
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NOTE: A provider may have multiple provider accounts if the provider bills for services using multiple Tax ID numbers. |
Complete the following steps to perform this tutorial:
Display the Provider Account Detail for Payee page.
View or update the provider's detail information.
Provider First Name displays the person's first name.
Middle Name displays the person's middle name.
Last Name displays the person's last name.
Agency/Billing Name displays the payee's name on the provider account (for billing purposes).
Provider Account ID displays the provider's identification number.
Medicaid ID displays the provider's individual Medicaid identification number (if the provider is enrolled with Medicaid).
Account Active Date displays the date on which the provider's account became active.
To displays the date through which the provider's account remains active.
Prov. Enrollment Date displays the date on which the provider enrolled with the CFO.
Degree displays the provider's degree.
E-Signature indicates whether the provider's electronic signature is currently on file with the CFO.
Prov. Acct. Address displays the current address information for the provider.
City displays the name of the city in which the provider is currently located.
State/Zip displays the name of the state and the ZIP code in which the provider is currently located. Depending on your permissions, you may be able to update the Zip code.
In Phone, enter one or more telephone numbers at which the person can be contacted. For more information about entering telephone numbers, see the Telephone Numbers topic.
In Email, enter the electronic mail address for the person. Email addresses must be entered in the format of: name@xxx.zzz. At least 10 characters must be entered, and you can enter up to 50 characters as necessary.
Click Save.
Version 1.6