Get the free Delaware Medical Assistance Provider Enrollment Packet

This document serves as an enrollment packet for group providers looking to enroll in the Delaware Medical Assistance Program, detailing requirements and necessary forms.

How to fill out delaware medical assistance provider

How to fill out Delaware Medical Assistance Provider Enrollment Packet

1. Download the Delaware Medical Assistance Provider Enrollment Packet from the official website.
2. Fill out the Provider Information section with accurate details.
3. Complete the individual or organizational information depending on the provider type.
4. Provide all required supporting documents, such as licenses, certifications, and identification.
5. Review the enrollment agreement and sign where indicated.
6. Submit the completed packet via mail or the designated electronic submission method.
7. Wait for confirmation of your enrollment and any further instructions from the medical assistance program.

Who needs Delaware Medical Assistance Provider Enrollment Packet?

1. Healthcare providers wishing to offer services to Delaware Medical Assistance recipients.
2. New providers entering the Delaware Medical Assistance program.
3. Existing providers who need to update their information or re-enroll after a lapse.

People Also Ask about

What is the income limit for Medicaid in Delaware?

You need to provide proof of Identity, U.S. Citizenship and/or Immigration Status and Date of Birth. Effective 7/1/10, citizen children who provide a social security number are not required to provide identity or citizenship documentation if eligible for Child Health Plus.

What is the phone number for Delaware Medicaid provider enrollment?

Medicaid furnishes medical assistance to eligible low-income families and to eligible aged, blind and/or disabled people whose income is insufficient to meet the cost of necessary medical services.

What documentation is required for Medicaid in Delaware?

State of Delaware - Search and Services/Information Enter your assigned tracking number and Tax ID to verify the current status of your enrollment application. For further questions, please contact Provider Services at (800) 999-3371 opt. 0 then 4. * Indicates a required field.

What is a provider enrollment form?

Provider Enrollment (or Payor Enrollment) refers to the process of applying to health insurance networks for inclusion in their provider panels. For Commercial Insurance networks, this process involves two steps, 1) Credentialing and 2) Contracting.

What is documentation required for Medicaid in Delaware?

You will need to provide verification of your income. You do not need to provide proof of your assets or resources (bank accounts, cars, stocks, etc.) or come into our offices to be interviewed unless you are applying for one of the Long Term Care Medicaid programs or Home and Community Based Services).

What paperwork do you need for Medicaid?

Proof of citizenship or immigration status. Proof of income, like paystubs or W-2s. A verification of what other government benefits you receive. Information about an insurance plan your employer has offered you or an insurance plan you currently have.

For pdfFiller’s FAQs

What is Delaware Medical Assistance Provider Enrollment Packet?

The Delaware Medical Assistance Provider Enrollment Packet is a document that healthcare providers must complete to enroll in the Delaware Medical Assistance Program, which provides health care services to eligible low-income individuals and families.

Who is required to file Delaware Medical Assistance Provider Enrollment Packet?

All healthcare providers wishing to participate in the Delaware Medical Assistance Program, including physicians, hospitals, therapists, and other healthcare facilities, are required to file the Delaware Medical Assistance Provider Enrollment Packet.

How to fill out Delaware Medical Assistance Provider Enrollment Packet?

To fill out the Delaware Medical Assistance Provider Enrollment Packet, providers must provide accurate and complete information regarding their practice, such as personal identification, professional credentials, and practice location details, following the instructions provided in the packet.

What is the purpose of Delaware Medical Assistance Provider Enrollment Packet?

The purpose of the Delaware Medical Assistance Provider Enrollment Packet is to ensure that providers meet eligibility criteria and comply with state regulations, enabling them to offer services and receive reimbursement from the Delaware Medical Assistance Program.

What information must be reported on Delaware Medical Assistance Provider Enrollment Packet?

Providers must report various information on the Delaware Medical Assistance Provider Enrollment Packet, including their legal business name, Federal Tax Identification Number, Medicaid provider type, and details of their healthcare services, as well as any prior disciplinary actions or criminal convictions.