Get the free DMS-844 Arkansas Medicaid PCMH Participation Agreement - humanservices arkansas
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Division of Medical Services Arkansas PatientCentered Medical Home Enrollment Unit 18663224696 (instate) or 15013018311 (local and out of state) TDD/TTY: 5016826789 ARKPCMH@dxc.comArkansas Medicaid
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How to fill out dms-844 arkansas medicaid pcmh
How to fill out dms-844 arkansas medicaid pcmh
01
Obtain a DMS-844 Arkansas Medicaid PCMH form
02
Read the instructions on the form carefully
03
Fill out the personal information section, including name, address, and contact details
04
Provide your Medicaid number and any other relevant identification numbers
05
Complete the section on medical history, including any current diagnoses or medications
06
Answer the questions regarding your primary care provider and any preferred providers
07
Include any additional information or documentation required
08
Review the completed form for accuracy and legibility
09
Sign and date the form
10
Submit the form to the appropriate Medicaid office or designated location
Who needs dms-844 arkansas medicaid pcmh?
01
Individuals who are eligible for Arkansas Medicaid and wish to participate in the Person-Centered Medical Home (PCMH) program need to fill out the DMS-844 Arkansas Medicaid PCMH form.
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What is dms-844 arkansas medicaid pcmh?
dms-844 Arkansas Medicaid PCMH stands for Arkansas Medicaid Patient-Centered Medical Home.
Who is required to file dms-844 arkansas medicaid pcmh?
Healthcare providers participating in the Arkansas Medicaid PCMH program are required to file dms-844 form.
How to fill out dms-844 arkansas medicaid pcmh?
To fill out dms-844 Arkansas Medicaid PCMH form, providers need to enter patient data, services provided, and other relevant information.
What is the purpose of dms-844 arkansas medicaid pcmh?
The purpose of dms-844 Arkansas Medicaid PCMH is to streamline the reporting process for healthcare providers participating in the program.
What information must be reported on dms-844 arkansas medicaid pcmh?
Information such as patient demographics, services provided, and provider details must be reported on dms-844 Arkansas Medicaid PCMH.
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