Get the free Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Par...

This document serves as an application for providers to certify their participation in the Maryland Healthy Kids/Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, outlining requirements

How to fill out maryland health kidsjava epsdt

How to fill out Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation

1. Obtain the Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation from the official Maryland Department of Health website.
2. Read the application instructions carefully to understand the requirements and eligibility criteria.
3. Fill out the provider information section, including your name, organization, and contact details.
4. Provide details about your professional qualifications, including licenses, certifications, and relevant training.
5. Specify the services you intend to provide under the EPSDT program and ensure they align with program guidelines.
6. Complete the sections on facilities and equipment, ensuring they meet health and safety standards.
7. Sign and date the application form to certify that the provided information is accurate and complete.
8. Gather any required documentation, such as proof of insurance and licensing.
9. Submit the completed application along with all supporting documents to the appropriate Maryland Health Department office.
10. Follow up after submission to check the status of your application.

Who needs Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation?

1. Health care providers who wish to offer services to children and adolescents under Maryland's EPSDT program and participate in the Medicaid program.
2. Organizations that provide preventive, diagnostic, and treatment services for eligible children.
3. Providers looking to expand their services to include pediatric health care and preventive services under the Maryland Health Kids program.

For pdfFiller’s FAQs

What is Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation?

The Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation is a formal application process that healthcare providers in Maryland must complete to participate in the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) program, which provides necessary health services for children.

Who is required to file Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation?

Healthcare providers who wish to offer services under the Maryland Health Kids/JAVA EPSDT Program must file this application to be certified as participating providers.

How to fill out Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation?

To fill out the application, providers should gather the required documentation, accurately complete all sections of the application form, and submit it to the appropriate state department for review.

What is the purpose of Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation?

The purpose of the application is to ensure that healthcare providers meet the necessary standards and qualifications to deliver EPSDT services to eligible children, thereby maintaining quality and accountability in the program.

What information must be reported on Maryland Health Kids/JAVA EPSDT Program Provider Application for Certification & Participation?

The application typically requires information including provider credentials, practice location, types of services offered, hours of operation, and other relevant details that demonstrate compliance with state and federal guidelines.