Provider Enrollment Application - Non-emergency Transportation Company is a legal document that was released by the Arizona Health Care Cost Containment System - a government authority operating within Arizona.
Q: What is a Provider Enrollment Application?
A: A Provider Enrollment Application is a form that non-emergency transportation companies in Arizona need to submit in order to enroll in the Medicaid program and provide services to Medicaid beneficiaries.
Q: Who needs to submit a Provider Enrollment Application?
A: Non-emergency transportation companies in Arizona who want to provide services to Medicaid beneficiaries need to submit a Provider Enrollment Application.
Q: What is the purpose of the Provider Enrollment Application?
A: The purpose of the Provider Enrollment Application is to review and verify the qualifications of non-emergency transportation companies in Arizona before they can be enrolled in the Medicaid program.
Q: What are the requirements for submitting a Provider Enrollment Application?
A: The specific requirements for submitting a Provider Enrollment Application may vary, but generally, non-emergency transportation companies need to provide information such as their business name, contact information, licensing details, and proof of compliance with applicable laws and regulations.
Q: Is there a fee for submitting a Provider Enrollment Application?
A: The application fees for a Provider Enrollment Application vary by state and provider type. Non-emergency transportation companies should check with their state's Medicaid program for specific fee information.
Q: How long does it take for a Provider Enrollment Application to be processed?
A: The processing time for a Provider Enrollment Application can vary depending on the state and the completeness of the application. It is best to reach out to the Medicaid program or enrollment contractor in your state for an estimated timeline.
Q: What happens after my Provider Enrollment Application is approved?
A: After your Provider Enrollment Application is approved, you will receive a provider number and be able to start providing non-emergency transportation services to Medicaid beneficiaries.
Q: What should I do if my Provider Enrollment Application is denied?
A: If your Provider Enrollment Application is denied, you should review the denial letter for specific reasons and follow the instructions provided to address any deficiencies or appeal the decision.
Q: Can I change my information after submitting a Provider Enrollment Application?
A: Yes, you can typically update your information after submitting a Provider Enrollment Application. Contact your state's Medicaid program or enrollment contractor for guidance on how to make changes.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Arizona Health Care Cost Containment System.