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Get Wellmark S-53260 2017

Ld Association S-53260 3/17 REGISTRATION INSTRUCTIONS Please note that a valid provider NPI is required in order to complete the ANSI 837 Electronic Transaction Registration Form. The registration form may be used to request a submitter number for submitting electronic claims using Web BBS or to add a provider to an existing submitter number. This registration form is applicable for Wellmark Blue Cross and Blue Shield, Blue Dental and applies to any of the following ANSI Transactions: 837, 27.

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