About Rural Health Care:

• Overview of the Program
• Overview of the Process
• Monthly Conference Calls
• Individual Outreach
• Understanding Audits
• Training Events
• Filing Appeals
• Rural Health Care Pilot Program

Rural Health Care Tools:

• Applicant Login
• Latest News
• Required Forms
• Tips and Best Practices
• Frequently Asked Questions
• Glossary of Terms
• Rural Health Care Search Tools
• Changes and Corrections
• Calendar/Reminders
• Program Compliance - Whistleblower Hotline
• Submitting A Complaint
• Submitting Your Feedback

Step 2: Service Request (Form 465)

All health care providers must complete the Description of Services Requested and Certification Form (FCC Form 465). FCC Form 465 is how HCPs request bids for eligible services.

An applicant indicates on a single FCC Form 465 whether it is applying for support for telecommunications service, Internet access discounts, or both. Form 465 is the health care provider's certification that it meets program eligibility requirements.

Each health care provider is assigned an HCP Number. The five-digit HCP Number is used by USAC to track applications and is a required field on all forms used in the application process. The HCP Number is consistent across multiple funding years. If an HCP has applied for support in previous funding years, it should not request a new HCP number.

If a health care provider does not have an HCP Number, it must complete an FCC Form 465 (see required forms) and mail it to the address on the form. If the health care provider is deemed eligible, an HCP Number will be issued and the FCC Form 465 is posted to the USAC website. A user-changeable password is issued with the HCP Number for use on the USAC website to complete forms or review specific information.

USAC recognizes that many HCPs belong to groups or consortia that share resources and negotiate with service providers. A separate FCC Form 465 must be completed for each health care provider at a different physical location within the consortium that is eligible to receive support.

New participants must complete, print, sign, and mail a paper Form 465 to USAC. After the initial paper FCC Form 465 is approved, participants may use the electronic application, also called e-certification. E-certification allows participants to electronically sign and immediately post an FCC Forms 465 on the USAC website. To expedite the review process, participants are encouraged to log in and complete Form 465 online. All participants that have successfully posted a Form 465 may enable e-certification.

Paper submissions of an FCC Form 465 must be signed and mailed to USAC for review and posting at:
Universal Service Administrative Company
Rural Health Care Program
30 Lanidex Plaza West
Parsippany, NJ 07054

First-time participants will receive a letter notifying them of their HCP Number and password if they are determined to be eligible. Paper filers will receive a letter confirming the posting and will be given the allowable carrier selection date, which is 28 days after the posting date. This is the first day an HCP may sign an agreement with a service provider. Participants that use e-certification for an FCC Form 465 will receive the confirmation letter by email.