Get the free Delaware Medical Assistance Provider Enrollment Packet

This document serves as an enrollment packet for individual providers wishing to enroll in the Delaware Medical Assistance Program, detailing required forms, guidelines, and provider types.

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. Read the instructions included in the packet carefully to understand the requirements.
3. Fill out the provider information section with accurate details including legal name, business address, and contact information.
4. Complete the sections related to provider type and specialty as applicable.
5. Provide documentation of licenses, certifications, and any other required credentials.
6. Sign and date the application form as required.
7. Submit the completed packet along with any supporting documents to the designated address or via the specified submission method.

Who needs Delaware Medical Assistance Provider Enrollment Packet?

1. Healthcare providers looking to offer services to Delaware Medical Assistance recipients.
2. Organizations or facilities intending to enroll as providers in the Delaware Medical Assistance Program.
3. Individual practitioners, such as physicians, therapists, or specialists, seeking reimbursement for services rendered to eligible recipients.

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 set of forms and documentation required for healthcare providers to enroll in the Delaware Medicaid program.

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

All healthcare providers who wish to participate in the Delaware Medicaid program and receive reimbursement for services provided to Medicaid beneficiaries are required to file the enrollment packet.

How to fill out Delaware Medical Assistance Provider Enrollment Packet?

To fill out the packet, healthcare providers should carefully complete each form included in the packet, providing accurate information about their practice, services, and ownership, and submit it to the appropriate state agency along with any required documentation.

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

The purpose of the packet is to gather necessary information about healthcare providers to ensure they meet the criteria for participation in the Medicaid program and to facilitate the reimbursement process.

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

The packet must include information such as the provider's legal business name, National Provider Identifier (NPI), tax identification numbers, service locations, and details about ownership and affiliations.