Instructions for Expedited Request to add Service Codes to Existing Contracted site(s)

 

  1. The Provider representative filling out and submitting the form must be a representative with authority to make changes/updates to information in Cardinal Innovations’ provider data system.

  2. This form may only be used for the addition of services to existing billing site locations in Cardinal Innovations’ system. A Cardinal Innovations’ site identification number will be required for the form. If the site is currently not in the Cardinal Innovations system for the provider, the request to add an additional site to the system must be made using the Additional Site Application at this link: https://www.cardinalinnovations.org/providers/network-providers/additional-site-service-applications

  3. Providers should obtain their Cardinal Innovations site identification numbers for their site(s) (“Site ID Nos.”) for the form from the Cardinal Innovations Provider Direct system. These ID Nos. appear on the Provider Management page in Provider Direct under the “Admin” tab.

  4. Providers should review their sites and contracted services and should only utilize the form to add services to a site that currently does not have those services in the system. Providers should avoid requests to add services that are duplicative of existing services already in the system.

  5. Certain services may not be available to be added by expedited request. If the service is not available in the drop-down menu to choose, an Additional Service Application at the link provided above will be necessary to process.