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Required Data from DMCA Contracted Providers State Fiscal Year 2017 July 2016 STATE OF INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION DIVISION OF MENTAL HEALTH AND ADDICTION 402 WEST WASHINGTON

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How to fill out dmha contracted providers

01

Step 1: Obtain the required forms and documents from the DMHA office.

02

Step 2: Carefully read and understand the instructions provided with the forms.

03

Step 3: Fill out the provider information section, providing accurate and complete details.

04

Step 4: Provide all necessary certifications and licenses as required.

05

Step 5: Attach any supporting documentation or additional forms as needed.

06

Step 6: Review the filled-out forms for any mistakes or omissions.

07

Step 7: Submit the completed forms to the DMHA office either in person or by mail.

08

Step 8: Await confirmation of approval or further instructions from the DMHA office.

09

Step 9: Once approved, make sure to comply with all DMHA regulations and guidelines as a contracted provider.

Who needs dmha contracted providers?

01

Individuals or organizations looking to provide services covered by DMHA.

02

Healthcare providers seeking reimbursement for DMHA-covered services.

03

Providers aiming to expand their network and reach more patients through DMHA partnerships.

04

Organizations dedicated to mental health and addiction recovery services.

05

Entities eligible for DMHA funding or grants.

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What is dmha contracted providers?

DMHA contracted providers are healthcare providers that have entered into a contract with the Division of Mental Health and Addiction (DMHA) to provide services to individuals with behavioral health needs.

Who is required to file dmha contracted providers?

Healthcare providers who have entered into contracts with the Division of Mental Health and Addiction are required to file dmha contracted providers.

How to fill out dmha contracted providers?

Providers can fill out the dmha contracted providers form online through the DMHA portal or submit a physical form via mail.

What is the purpose of dmha contracted providers?

The purpose of dmha contracted providers is to track and monitor the services provided by contracted healthcare providers to individuals with behavioral health needs.

What information must be reported on dmha contracted providers?

Providers must report detailed information about the services provided, the number of individuals served, and any outcomes or impacts of the services.

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