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Version 1/Revision 3-Page 1 of 23 spaces PA/DVS Request REFERENCE GUIDE Table of Contents PA/DVS Request ............................................................................................................................2
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What is epaces dvs form for?
The ePACES DVS form is used to report certain changes and updates to the New York State Department of Health (NYSDOH) regarding Medicaid enrollment and certification.
Who is required to file epaces dvs form for?
Healthcare providers and organizations enrolled in the New York State Medicaid program are required to file the ePACES DVS form.
How to fill out epaces dvs form for?
To fill out the ePACES DVS form, providers and organizations must log in to the ePACES portal and navigate to the DVS section. They need to enter the required information accurately as per the instructions provided.
What is the purpose of epaces dvs form for?
The purpose of the ePACES DVS form is to ensure that the NYSDOH has up-to-date and accurate information regarding Medicaid enrollment and certification for healthcare providers and organizations.
What information must be reported on epaces dvs form for?
The ePACES DVS form requires the reporting of changes such as provider address, contact information, practice locations, billing agents, and enrollment status. Additionally, any updates to services, specialties, or certifications should also be reported.
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