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Update Your Practice Demographic Information

It’s important to keep us up to date!

To meet Centers for Medicare & Medicaid Services (CMS) requirements, support claim accuracy and timely reimbursements, and to provide our members with up-to-date information, all care providers contracted with HCP must keep their demographic information up-to-date.

To submit a demographic change, please fill out this demographic form, and fax
the completed form to (516) 746 – 8473.

If you need assistance or have any questions, please contact Customer Service at
(800) 877 – 7587.