This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Provider Application for Certification & Participation - Healthy Kids/Early and Periodic Screening, Diagnosis and Treatment (Epsdt) Program is a legal document that was released by the Maryland Department of Health - a government authority operating within Maryland.
Q: What is the Healthy Kids/EPSDT program in Maryland?
A: The Healthy Kids/EPSDT program in Maryland is a program that provides health care services for eligible children.
Q: Who can apply for certification and participation in the Healthy Kids/EPSDT program?
A: Providers who want to participate in the Healthy Kids/EPSDT program can apply for certification and participation.
Q: What is the purpose of the Provider Application for Certification & Participation form?
A: The Provider Application for Certification & Participation form is used to request certification and participation in the Healthy Kids/EPSDT program.
Q: Are there any requirements for providers to be eligible for certification and participation?
A: Yes, providers must meet certain requirements to be eligible for certification and participation in the Healthy Kids/EPSDT program.
Q: What are some of the requirements for providers to participate in the Healthy Kids/EPSDT program?
A: Some of the requirements for providers to participate in the Healthy Kids/EPSDT program include being licensed or certified in their field, meeting certain qualifications, and complying with program policies and standards.
Q: What services are covered under the Healthy Kids/EPSDT program?
A: The Healthy Kids/EPSDT program covers a wide range of health care services for eligible children, including preventive care, screenings, diagnoses, and treatment.
Q: How can providers submit the completed Provider Application for Certification & Participation form?
A: Providers can submit the completed Provider Application for Certification & Participation form to their local health department.
Form Details:
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Maryland Department of Health.