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Form INS5036 Standardized Credentialing Form - Part B: Agency / Program / Organization Providers - Ohio
What Is Form INS5036?
This is a legal form that was released by the Ohio Department of Insurance - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the purpose of Form INS5036?A: Form INS5036 is used for standardized credentialing of Agency/Program/Organization Providers in Ohio.
Q: What is Part B of Form INS5036?A: Part B of Form INS5036 is specifically for Agency/Program/Organization Providers.
Q: Who should fill out Part B of Form INS5036?A: Only Agency/Program/Organization Providers in Ohio need to fill out Part B of Form INS5036.
Q: What information is required in Part B of Form INS5036?A: Part B of Form INS5036 requires information about the agency/program/organization, including contact details, services provided, and provider qualifications.
Form Details:
- Released on January 1, 2019;
- The latest edition provided by the Ohio Department of Insurance;
- 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 fillable version of Form INS5036 by clicking the link below or browse more documents and templates provided by the Ohio Department of Insurance.
Download Form INS5036 Standardized Credentialing Form - Part B: Agency / Program / Organization Providers - Ohio
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