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This document serves as a profile form for providers offering attendant care services, listing mandatory and optional categories of service, reimbursement type, and requirements for maintaining records
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How to fill out provider type profile
How to fill out PROVIDER TYPE PROFILE
01
Gather all necessary information about your practice or organization.
02
Determine your primary type of provider (e.g., physician, therapist, clinic).
03
Fill in your basic contact details such as name, address, and phone number.
04
Provide information on specialties or services offered.
05
Include details about your licensing and certification.
06
Specify any relevant affiliations or partnerships.
07
Review all information for accuracy before submission.
Who needs PROVIDER TYPE PROFILE?
01
Healthcare providers looking to identify their service type.
02
Organizations needing to categorize their offerings for patients.
03
Insurance companies to assess provider qualifications.
04
Patients seeking specific types of healthcare services.
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People Also Ask about
What is a provider type 77?
Our Provider Services representatives are skilled to provide help to many basic claims questions. To reach Provider Services call (602) 417-7670. Provider Services Operation Hours: Monday-Friday from 8:00 A.M. - 5:00 P.M.
What is provider specialty 076?
076. Peripheral Vascular Diseases - Medical or Surgical (Osteopaths only)
What provider type is a PhD?
Doctor. A doctor is a medical professional with an MD, a PhD, or any other doctoral degree that treats patients with medical conditions. A doctor may, for example, be a physician, psychologist, neurologist, surgeon, dentist, or dermatologist.
What is a provider type?
Examples of AHCCCS provider type in a sentence For the purposes of this policy, a Behavioral Health Outpatient and Integrated Clinic is defined as a facility operating using AHCCCS provider type 77 “Behavioral Health Outpatient Clinic” and IC “Integrated Clinic”.
What provider type is a podiatrist?
Yes, podiatrists are doctors. Podiatrists have a doctor of podiatric medicine (DPM) degree and attend a specialized podiatric medical school.
What is a provider type code?
A code describing the type of provider (i.e. doctor or facility) responsible for treating a patient. This represents the attending physician if available. If the state uses state-specific codes, they should map their internal codes to the CMS standard list provided.
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What is PROVIDER TYPE PROFILE?
The PROVIDER TYPE PROFILE is a document or form that outlines the specific types of services offered by a provider, along with relevant details about their qualifications, practices, and operations.
Who is required to file PROVIDER TYPE PROFILE?
Entities operating as healthcare providers, such as hospitals, clinics, and individual practitioners, are typically required to file a PROVIDER TYPE PROFILE to ensure compliance with regulatory requirements.
How to fill out PROVIDER TYPE PROFILE?
To fill out a PROVIDER TYPE PROFILE, providers need to gather necessary information regarding their services, credentials, and operational details, and then accurately complete the form according to provided instructions.
What is the purpose of PROVIDER TYPE PROFILE?
The purpose of the PROVIDER TYPE PROFILE is to provide a standardized way to collect and verify information about healthcare providers, facilitating transparency and regulatory compliance.
What information must be reported on PROVIDER TYPE PROFILE?
The information that must be reported includes provider identification details, types of services offered, qualifications, licensing information, and any relevant operational practices or affiliations.
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