How do I deactivate a Provider Secured Services ID?
To deactivate a Provider Secured Services ID that is no longer being used, list the following on your company letterhead (fax coversheet is not acceptable):
- Office name
- Office address
- The user ID
- Users name
- Contact person name and e-mail address
- A short note explaining that you would like the ID deactivated
- Signature and title from a manager, provider or authorized individual with legal signing authority.
Fax the information to 1-800-495-0812.