Provider Network Form A
How do I file?
Submit an electronic report by the 5th of each month. Your report must show all participating providers by network. Format your report according to Provider Network Form A (PDF, 26KB)
Follow the FTP Filing and Format Instructions (PDF, 88KB) and submit your report in the Network Access Portal.
Note: You'll need a user ID and password. If you don't have them, call OIC Network Access at 360-725-7127.
Use the HCP Validation (zip.exe, 138KB) program and codes. Use the following with the participating provider filings:
Note: Please use these instructions for running the HCPValid program.