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Facility/Agency/Organization (FAO)

A Facility / Agency / Organization (FAO) provider is an entity that provides health care services. An FAO includes Hospitals, Nursing Facilities, Laboratories, etc., and have a Type 2 NPI number associated to them. Providers who need to associate to an FAO will need to wait until the FAO enrollment application has been approved in CHAMPS.

  • CHAMPS Enrollment Application: FAO User Guide - PDF
    • Step 2: Add Locations - PDF 
    • Step 3: Add Specialties - PDF
    • Step 13: Fee Payment - PDF
  • Brain Injury Specialty FAO Enrollment Instructions- PDF
  • How to associate a billing agent and authorize the 835 - PDF
  • Provider Controlling Interest/Ownership Tip - PDF 
  • Quick Reference Guide - PDF
  • Revalidation Instructions - PDF
  • Track Application - PDF

Domain Administrator Resources



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