Faxing Instructions

STEP ONE – Gather Information

  1. First and last name patient/client
  2. Last four SSN of patient/client
  3. What information you are requesting regarding the patient/client
  4. Facility / office name
  5. Facility / office address
  6. Facility / office phone number
  7. Facility / office fax number
  8. Facility / office email address
  9. Facility / office contact person
  10. Confirmation that facility will agree with request / time frame
  11. Patient / client first name
  12. Patient / client last name
  13. Patient / client last four digits of SSN
  14. Relationship of requester of patient/client
  15. Payment Information – We except all major credit cards.

STEP TWO – Pay Online

  1. We except all major credit cards.
  2. Start by clicking the Begin Button.
  3. Follow the prompts and enter in the correct information.
  4. On the confirmation page click on the FAX SERVICE button.

STEP THREE – Complete Data Request

  1. Complete the data requested to send out the fax. (This is the information you gathered before starting.)
  2. Click on the Submit Button. (This will process your request, sending the request to the entity that has the information.)

STEP FOUR – Check your email to receive your receipt and confirmation.

If you have questions please contact us at:
Credentialing USA, Inc.
Ph. 605-214-1401
Fx. 605-610-2241
Email: info@credentialingusa.com
Website: www.CredentialingUSA.com