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3353 Form AO 85 Notice, Consent, and Order of Reference

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3353 Form AO 85 Notice, Consent, and Order of Reference

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Instructions and help about 3353 Form AO 85 Notice, Consent, And Order Of Reference

Hi and thanks for taking the time to watch this video today. I'm Thom Ryan with Provider Outreach and Education at WPS Government Health Administrators. This video is on completing the CMS provider enrollment form 855I for physicians and non-physician practitioners. This video focuses on completing section 13 for the contact person. First, I'll provide an explanation of who the contact person is. Our provider enrollment department will contact this person, versus the medical professional, for information regarding the application if development is needed or questions arise. This is during the processing of the application. The contact person is not an authorized or delegated official to work on behalf of the professional, they only work with this application. The next question to answer is, do you need to complete section 13? Section one is used to indicate what actions you are taking on the application. To the right of the action, it indicates that you

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