Provider Attestation Form

Colorado Behavioral Therapy Provider Attestation Download Printable PDF

Provider Attestation Form. Web provider based status attestation statement main provider’s medicare provider number: 7:00 am to 5:00 pm ct (8:00 am to 5:00 pm et).

Colorado Behavioral Therapy Provider Attestation Download Printable PDF
Colorado Behavioral Therapy Provider Attestation Download Printable PDF

7:00 am to 5:00 pm ct (8:00 am to 5:00 pm et). Web provider based status attestation statement main provider’s medicare provider number:

7:00 am to 5:00 pm ct (8:00 am to 5:00 pm et). 7:00 am to 5:00 pm ct (8:00 am to 5:00 pm et). Web provider based status attestation statement main provider’s medicare provider number: