Client Implementation Questionnaire - file anthem 2026

1. Click ‘Get Form’ to open the Client Implementation Questionnaire in the editor.
2. Begin with Section 1: Group Information. Enter the group name as it should appear on billing statements, followed by the mailing address and contact details.
3. Proceed to Section 2: Decision Maker. Fill in the name, title, and contact information of the individual responsible for major decisions regarding your account.
4. In Section 3: Group Administrator, provide details for the person handling non-billing issues. Ensure all fields are completed accurately.
5. Continue to Section 4: Designated HIPAA Representative. This section requires information about the individual authorized to handle protected health information.
6. For Section 5: Billing Contact, indicate who will manage billing-related inquiries. If this is the same as a previous contact, simply note 'same'.
7. Complete Sections 6 through 19 by following similar instructions for each section, ensuring all required fields are filled out thoroughly.

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