Forms
Nurse Practitioner Service Encounter Reporting and Tracking (SERT)
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4752-84 | Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI) | Fill & Print |
4751-84 | Interdisciplinary Health Provider (IHP) Nurse Practitioner (NP) Authorization for Participation in the NP Service Encounter Reporting and Tracking (SERT) Initiative | Fill & Print |
4750-84 | Application for IHP GONet Electronic Data Transfer (EDT) Service | Fill & Print |
4749-84 | IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement | Fill & Print |
4747-84 | Application for IHP Claims Submission and Remittance Advice in Machine Readable Input (MRI) | Fill & Print |
4746-84 | Interdisciplinary Health Provider (IHP) Health Number Release | Fill & Print |
4744-84 | Interdisciplinary Health Provider (IHP) Application for Direct Bank Payment | Fill & Print |
4722-84 | Application for IHP Group Registration | Fill & Print |
4721-84 | IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP) | Fill & Print |