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How to use or fill out performant discussion period request form with our platform
- Click ‘Get Form’ to open the performant discussion period request form in the editor.
- Begin by entering your Provider/Supplier Name, NPI, TAX-ID, and CLAIM# in the designated fields. Ensure all information is accurate to avoid processing delays.
- Select the Type of Audit from the options provided: Automated, Complex, or Semi-Automated. For Automated and Semi-Automated audits, enter the Date of MAC Demand Letter as required.
- Indicate whether you have Additional Documentation Attached by selecting 'Yes' or 'No'. If you disagree with the RA’s decision, provide detailed reasons in the space provided.
- Sign and date the form at the bottom. Include your Printed Name, Phone number, and E-mail for further communication.
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What is the best way to send my discussion period request form for eSignature?
Upload your discussion period request form to DocHub (after you’ve created an account for this). If you need to complete fields in it, use appropriate tools from the top pane. For instance, add Signature Fields, assign each to a particular party, and click on Sign → Request signatures from others. Customize your message for your recipients and click Send Request. You can also send your paperwork by fax or as a Signing link instead of using email (you’ll find these options by navigating to the Menu → Send)
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