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Client Specific Forms

CMS/Medicare

  • CMS 855A  - Medicare Enrollment Application - Institutional Providers
  • CMS 855B  - Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers
  • CMS 855I  - Medicare Enrollment Application - Physicians and Non-Physician Practitioners
  • CMS 855R  - Medicare Enrollment Application - Reassignment of Medicare Benefits
  • CMS 855S - Medicare Enrollment Application - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers

HIPAA

HITECH

IRS Forms

  • Form W-9PDF - IRS - Request for Taxpayer ID Number and Certification