Practice and Provider Data Questionnaire

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Background
The Centers for Medicare and Medicaid Services (CMS) has provided guidance on data elements which are required for tracking and which will be published in Buckeye Health Plan's Provider Directory. These data elements need to be collected at this time and will be required to be updated regularly.

This brief questionnaire has been designed to easily collect this information by location. Please answer this to the best of your knowledge, and ensure you answer every question. If an answer is blank, Buckeye Health Plan will assume your location does not provide that service.