212.000 Practice Enrollment (Arkansas Medicaid PCMH Manual)212.000 Practice Enrollment (Arkansas Medicaid PCMH Manual) A physician may be affiliated with only one participating practice
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212.000 Practice Enrollment (Arkansas Medicaid PCMH Manual) A physician may be affiliated with only one participating practice. A participating practice must update the Department of Human Services (DHS) on changes to the list of physicians who are part of the practice. Physicians who are no longer participating with a practice are required to update in writing via email at [email protected]within 30 days of the change. The update/change form is located on the Payment Initiative website - http://www.paymentinitiative.org/Websites/paymentinitiative/images/Update-Change%20Form.pdf. This form should be completed and submitted to [email protected]when: • You have a provider leaving your practice • You have a provider joining your practice • Your contact lead(s) contact information changes
212.000 Practice Enrollment (Arkansas Medicaid PCMH Manual) A
physician may be affiliated with only one participating practice. A
participating practice must update the Department of Human Services
(DHS) on changes to the list of physicians who are part of the
practice. Physicians who are no longer participating with a
practice are required to update in writing via email at
[email protected] within 30 days of the change. The update/change
form is located on the Payment Initiative website -
http://www.paymentinitiative.org/Websites/paymentinitiative/images/Update-Change%20Form.pdf.
This form should be completed and submitted to [email protected]
when:
• You have a provider leaving your practice • You have a
provider joining your practice • Your contact lead(s) contact
information changes
