Submit Modification Request for Review (3 minutes)

Upload Documents (5 minutes)

Complete Modification Checklist (4 minutes)

Update Billing Agent Association (8 minutes)

Update Mode of Claim Submission/EDI (6 minutes)

Update Billing Provider Association (6 minutes)

Update MCO Plan Association (2 minutes)

Update 835/ERA Enrollment Form (4 minutes)

Update Payment Details (4 minutes)

Update Additional Information (5 minutes)