Electronic File Interchange Organization (EFIO) Certification Statement {CMS-10175} | Pdf Fpdf Docx | Official Federal Forms

 Official Federal Forms   Centers For Medicare And Medicaid Services 
Electronic File Interchange Organization (EFIO) Certification Statement {CMS-10175} | Pdf Fpdf Docx | Official Federal Forms

Last updated: 5/17/2023

Electronic File Interchange Organization (EFIO) Certification Statement {CMS-10175}

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Description

CMS-10175 - ELECTRONIC FILE INTERCHANGE ORGANIZATION (EFIO) CERTIFICATION STATEMENT. The EFIO is legally bound to adhere to several conditions, including having the authority to act on behalf of providers when submitting information to CMS or its agent, submitting accurate and up-to-date data, notifying providers of their NPI issuance or rejection, maintaining records and files, cooperating with the Enumerator in verification processes, promptly addressing provider concerns, and ensuring truthful and correct information submission. The EFIO must also comply with federal law and state law, and any false or misleading information may result in penalties. www.FormsWorkflow.com

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