Provider Information Submission Agreement Sample Contracts

Department of Health and Social Services PROVIDER INFORMATION SUBMISSION AGREEMENT‌
Provider Information Submission Agreement • March 14th, 2024

The following constitutes an Information Submission Agreement between a provider enrolled in the Alaska Department of Health and Social Services Medical Assistance Program (“Provider”), and the State of Alaska, Department of Health and Social Services (“State”). The terms of this agreement govern the submission of clinical and financial information sent to the State in support of services performed by the Provider.

AutoNDA by SimpleDocs

Standard Contracts

Department of Health and Social Services PROVIDER INFORMATION SUBMISSION AGREEMENT
Provider Information Submission Agreement • October 10th, 2013

The following constitutes an Information Submission Agreement between a provider enrolled in the Alaska Department of Health and Social Services Medical Assistance Program (“Provider”), and the State of Alaska, Department of Health and Social Services (“State”). The terms of this agreement govern the submission of clinical and financial information sent to the State in support of services performed by the Provider.

Medicaid of Alaska
Provider Information Submission Agreement • November 18th, 2019

To start sending your Medicaid of Alaska claims through DentalXChange you will need to follow the instructions below required by the payer.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!