Ohio contact 2026

1. Click ‘Get Form’ to open the Ohio Contact Information form in the editor.
2. Begin by entering the Health Plan Issuer (HPI) Name(s) in the designated field. Ensure accuracy as this identifies your organization.
3. Next, input the HPI FEIN Number. This is crucial for identification and compliance purposes.
4. Fill out the HPI Contact Information section. Enter the contact's first name, last name, middle initial, email address, phone number, and extension if applicable.
5. Indicate whether this contact works for a Third Party Administrator (TPA). If yes, provide the TPA Name and FEIN Number.
6. Select all applicable HPI Contact Roles from the provided options. Be mindful that certain roles are restricted to person contacts only.
7. Finally, complete the authorization section with details of a manager or officer who can authorize access to the External Review System.

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