Submit Modification Request for Review (3 minutes)

Update Additional Information (5 minutes)

Update Billing Provider Association (6 minutes)

Update MCO Plan Association (2 minutes)

Complete Modification Checklist (4 minutes)

Upload Documents (5 minutes)

Update Provider Controlling Interest/Ownership Details (6 minutes)

Update License and Certifications (6 minutes)

Update Taxonomy Details (6 minutes)

Update Specialties (7 minutes)