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Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form - California
Medi-Cal Ground Emergency Medical Participation Agreement Form is a legal document that was released by the California Department of Health Care Services - a government authority operating within California.
FAQ
Q: What is the Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement ProgramProvider Participation Agreement Form?
A: The form used by healthcare providers in California to participate in the Gemt Supplemental Reimbursement Program for Medi-Cal Ground Emergency Medical Transportation Services.
Q: Who uses the Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form?
A: Healthcare providers in California that offer Medi-Cal Ground Emergency Medical Transportation Services and want to participate in the Gemt Supplemental Reimbursement Program.
Q: What is the purpose of the Gemt Supplemental Reimbursement Program?
A: The program provides additional reimbursement to healthcare providers for providing ground emergency medical transportation services to Medi-Cal patients.
Q: What information is required on the Provider Participation Agreement Form?
A: The form requires provider information, service location details, and an agreement to comply with program requirements.
Form Details:
- The latest edition currently provided by the California Department of Health Care Services;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form - California
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