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01. Edit your slp contracting online
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02. Sign it in a few clicks
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03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out slp contracting with our platform
- Click ‘Get Form’ to open the slp contracting application in the editor.
- Begin by filling out your practitioner information. Select your provider type (OT, PT, or SLP) and enter your first name, last name, NPI, social security number, date of birth, and license numbers.
- Next, provide practice location information. Specify whether this is your primary or secondary practice and include the practice name, tax ID number, address, email, and phone number.
- Complete the additional practice locations section if applicable. List any other sites where you will provide services using the same NPI.
- Fill in billing address details and ensure that all required fields are completed to avoid delays in processing.
- Review the signature waiver section and select your preference regarding claim form signatures before signing and dating the application.
- Finally, fax your completed application to 617-246-5053 and keep a copy for your records.
Start using our platform today for free to streamline your slp contracting process!
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