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Form DOH-4403 Tpa / Aso Status Change - New York
What Is Form DOH-4403?
This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is form DOH-4403?A: Form DOH-4403 is a document used for Tpa/Aso status change in New York.
Q: What is Tpa/Aso?A: Tpa/Aso refers to Third Party Administrator/Accountable Service Organization, which are entities that provide administrative support to healthcare providers in managing insurance claims.
Q: When is form DOH-4403 used?A: Form DOH-4403 is used when there is a change in Tpa/Aso status in New York.
Q: What information is required on form DOH-4403?A: Form DOH-4403 requires information such as the Tpa/Aso name, address, contact information, and the reason for the status change.
Q: Do I need to submit form DOH-4403 for Tpa/Aso status change in New York?A: Yes, you need to submit form DOH-4403 for Tpa/Aso status change in New York.
Form Details:
- Released on May 1, 2012;
- The latest edition provided by the New York State Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form DOH-4403 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.
Download Form DOH-4403 Tpa / Aso Status Change - New York
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