Provider Information Submission Agreement Sample Contracts
Department of Health and Social Services PROVIDER INFORMATION SUBMISSION AGREEMENTProvider 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.
Standard Contracts
Department of Health and Social Services PROVIDER INFORMATION SUBMISSION AGREEMENTProvider 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 AlaskaProvider 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.
