Professional Documents
Culture Documents
Dear Customer
Dear Customer
Dear Customer
Madam: We are processing your application to our client health plan.This process include primary source verification of several informational items provided to you in the application to the health plan.We have identified a discrepancy between the information provided on your application and the verification information we received.Please provide a detailed explanation and/or clarification of the information you provided so we can proceed with your credentialing. Information provided on application: _____________________ _____________________ Information obtained by primary source verification: _____________________ _______________________ Please return a written explanation and/or clarification of the above discrepancy within ten (10) business days. Failure to response within ten (10) business days will result in return of the incomplete application to the health plan. Your credentialing will not be complete without this explanation and/or clarification. Thank you for your timely response to this inquiry. Sincerely, Credentialing Coordinator Enclosure: Envelope
Thank you for using our services! Phone: 702-750-1034, Fax: 702-463-5572, URL: http://localhost:4328/Optima/