Form INS5036 Part B Standardized Credentialing Form: Agency / Program / Organization Providers - Ohio

Form INS5036 Part B Standardized Credentialing Form: Agency / Program / Organization Providers - Ohio

What Is Form INS5036 Part B?

This is a legal form that was released by the Ohio Department of Insurance - a government authority operating within Ohio.The document is a supplement to Form INS5036, Standardized Credentialing Form - Part B: Agency/Program/Organization Providers. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form INS5036?A: Form INS5036 is the Standardized Credentialing Form.

Q: What does Part B of Form INS5036 cover?A: Part B of Form INS5036 covers Agency/Program/Organization Providers in Ohio.

Q: Who are considered Agency/Program/Organization Providers?A: Agency/Program/Organization Providers refer to entities that provide services or programs in Ohio.

Q: What information does Part B of Form INS5036 require from Agency/Program/Organization Providers?A: Part B of Form INS5036 requires various information such as the agency's name, address, contact information, services provided, and other details about the organization.

Q: Why is Form INS5036 important?A: Form INS5036 is important for credentialing agencies to gather standardized information from providers and ensure compliance with regulations.

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Form Details:

  • Released on February 1, 2021;
  • 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 Part B by clicking the link below or browse more documents and templates provided by the Ohio Department of Insurance.

Download Form INS5036 Part B Standardized Credentialing Form: Agency / Program / Organization Providers - Ohio

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