Get the free Delaware Medical Assistance Provider Enrollment Packet

This document serves as a provider enrollment application for individuals seeking to enroll in the Delaware Medical Assistance Program as Medicare Crossover providers, allowing them to bill after

How to fill out delaware medical assistance provider

How to fill out Delaware Medical Assistance Provider Enrollment Packet

1. Gather all necessary documentation, including your professional qualifications and credentials.
2. Obtain the Delaware Medical Assistance Provider Enrollment Packet from the official website or requesting it directly from the Delaware Division of Medicaid and Medical Assistance.
3. Fill out the packet carefully, ensuring all sections are completed accurately.
4. Provide your National Provider Identifier (NPI) number in the appropriate section.
5. Include a valid and complete billing address and contact information.
6. Submit any required supplementary documents such as proof of licensure and liability insurance.
7. Review the completed packet for any errors or omissions before submission.
8. Submit the filled-out packet and all required documents to the designated office address provided in the instructions.

Who needs Delaware Medical Assistance Provider Enrollment Packet?

1. Healthcare providers intending to serve Delaware Medical Assistance recipients.
2. Individuals or organizations looking to participate in the Delaware Medicaid program.
3. Providers needing reimbursement for services rendered to eligible patients under Delaware's Medicaid program.

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 as providers in the Delaware Medicaid program, enabling them to receive reimbursement for services rendered to Medicaid beneficiaries.

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

Healthcare providers who wish to participate in the Delaware Medicaid program and receive payments for services provided to Medicaid recipients 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 carefully complete sections detailing their practice information, services offered, credentials, and any applicable certifications. It is important to follow the instructions provided in the packet for accurate submission.

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

The purpose of the Delaware Medical Assistance Provider Enrollment Packet is to collect necessary information from healthcare providers to verify their qualifications, assess their eligibility, and facilitate their enrollment in the state's Medicaid program.

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

Information that must be reported includes provider identification details, professional background, licensing information, practice location, types of services offered, and any relevant financial disclosures or agreements.