AR DMS-2609 2018-2025 free printable template

ARKANSAS MEDICAID PRIMARY CARE PHYSICIAN MANAGED CARE PROGRAM PRIMARY CARE PHYSICIAN SELECTION AND CHANGE FORM Member Information: First Nameless NameMiddle Initial Medicaid ID×Social Security #Birth

How to fill out AR DMS-2609

How to fill out AR DMS-2609

1. Gather all necessary information including personal details, contact information, and relevant documentation.
2. Download the AR DMS-2609 form from the official website or obtain a physical copy.
3. Start by filling out your personal information accurately in the designated sections.
4. Provide your contact details, ensuring they are up-to-date.
5. Include any supporting documents required for the application.
6. Review the completed form for any errors or missing information.
7. Sign and date the form where indicated.
8. Submit the form as instructed, either online or via mail, depending on the requirements.

Who needs AR DMS-2609?

1. Individuals applying for certain government services or benefits.
2. Anyone who is required to verify identity or eligibility for programs.
3. Residents who need to update their personal information with state agencies.

What is 855 372 1084 email Form?

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855 372 1084 email template instructions

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People Also Ask about

What is the phone number for Arkansas Medicaid provider?

Learn more about enrolling as an Arkansas Medicaid provider. If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at 501-376-2211 or 1-800-457-4454 toll-free.

What is the phone number for Arhome Medicaid?

ARHOME encourages you to be an active partner with your health care plan and work together to reach your health and well-being goals. A healthy Arkansas is a thriving Arkansas! If you have any questions about your health care coverage, contact your plan directly or call 1-888-987-1200.

How do I contact Medicaid in Arkansas?

The Arkansas Department of Human Services (DHS) administers the Arkansas Medicaid program. DHS's local county offices are the point of contact and primary resource for Medicaid beneficiaries and applicants. Beneficiaries and applicants may also contact Client Assistance at (800) 482-8988.

What is the phone number for Arkansas Medicaid provider relations?

Learn more about enrolling as an Arkansas Medicaid provider. If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at 501-376-2211 or 1-800-457-4454 toll-free.

Who do I contact in Arkansas about Medicaid?

Other Important Numbers Arkansas Medicaid Claims Questions Information Line (coverage, bills, beneficiary denial letters, or other services)1-800-482-5431Arkansas Medicaid Complaint Hotline (for complaints about healthcare)1-888-987-12002 more rows

How do I change my Medicaid provider in Arkansas?

The Toll-Free Telephone Helpline, 1-800-275-1131, operates Monday through Friday 6:00 am to 8:00 pm. ConnectCare Helpline Specialists assign or change PCPs at the request of Medicaid and ARKids First beneficiaries.

How do I contact Arkansas Medicaid provider enrollment?

If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or toll free at (800) 457-4454. When prompted, select 0 for “Other Inquiries”, then option 3 for “Provider Enrollment”.

Who do I call about Medicaid in Arkansas?

For Medicaid Clients Arkansas Medicaid General Customer Assistance, Telecommunication Device for the Deaf (TDD)1-501-682-8933Help Desk – Lost/did not get Medicaid Card, Eligibility1-800 482-8988 or 501-682-8233 – Available Monday-Friday 8-4:30 p.m.7 more rows

How do I check my Arkansas Medicaid status?

Enrollment Status. Enter your assigned tracking number and Tax ID (Employee Identification Number or Social Security Number) to verify the current status of your enrollment application. For any further queries, please contact Provider enrollment at (501) 376-2211 or (800) 457-4454 option 0 then 3.

What is the provider number for Arkansas Medicaid?

If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or (800) 457-4454.

How do I get a replacement Medicaid card in Arkansas?

If you lose your card, call 1-800-482-8988 as soon as you notice your card is missing.

How do I find my Medicaid number in Arkansas?

People Also Ask about arkansas medicaid id number lookup You can contact Department of Human Services (DHS) by calling 1-855-372-1084. If you cannot call 1-855-372-1084, go to a local DHS office.

What is the income limit for Medicaid in Arkansas?

Who is eligible for Arkansas ARKids First!? Household Size*Maximum Income Level (Per Year)1$30,7642$41,6103$52,4554$63,3004 more rows

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What is AR DMS-2609?

AR DMS-2609 is a form used for reporting specific financial or operational data required by regulatory agencies in certain jurisdictions, particularly in the context of the state of Arkansas.

Who is required to file AR DMS-2609?

Entities or individuals engaged in activities that fall under the reporting requirements set by the Arkansas Department of Motor Vehicles or relevant regulatory authority are required to file AR DMS-2609.

How to fill out AR DMS-2609?

To fill out AR DMS-2609, gather the necessary information as specified in the guidelines, complete all sections accurately, and ensure that required documentation is attached before submission.

What is the purpose of AR DMS-2609?

The purpose of AR DMS-2609 is to collect data relevant to the monitoring and regulation of certain activities, aiding in compliance and ensuring adherence to state laws.

What information must be reported on AR DMS-2609?

Information that must be reported on AR DMS-2609 typically includes identification details of the filer, specifics about the activities being reported, financial data, and any other required disclosures as outlined in the form's instructions.