For CHIP providers, please contact your designated CHIP Managed Care Organization(s).įingerprint-based Criminal Background Checks Providers who wish to submit multiple applications (for multiple service locations) and pay one fee should use the "Initiate Additional Application" feature and submit all applications within 7 days.įor more information about the application fee, please see the ACA Enrollment Application Fee Medical Assistance Bulletin. The department will assess and collect one fee for multiple applications submitted by one provider in a 7 day time period. To pay an application fee, providers must enroll and revalidate through the Electronic Provider Enrollment Application. The department will notify the provider of the CMS’ decision. CMS will determine whether or not to grant the hardship exception and communicate the information back to the department. If an exception is requested, the provider will be prompted to submit (upload) documentation. Providers may request a hardship exception to the application fee requirement. The Centers for Medicare & Medicaid Services (CMS) sets the amount of the application fee every year. Refer to 42 CFR 455, Subpart E – Provider Screening and Enrollment, Section 455.460 for the complete regulation. The Affordable Care Act requires states to collect an application fee, if applicable, prior to executing a provider agreement from a prospective or re-enrolling provider. Providers must logon to the portal to initiate an application if they are active or have been closed for less than 2 years. Select one of the provider enrollment links to the left to start an application, resume an existing application, or to check the status of an application.Īctive Providers or Providers Closed for Less Than 2 Years New Providers or Providers Closed for More Than 2 Years You will receive a response upon approval or denial of your enrollment with PA Medicaid and/or CHIP. Please retain copies of your application materials for your records. All applications will be screened based on Federal and State guidelines prior to an enrollment decision. This includes providers who are not billing PA Medicaid or CHIP but provide services to beneficiaries. To enroll, providers can complete an on-line provider enrollment application and supply any required supporting documentation. Other providers must be approved, licensed, issued a permit, certified by the appropriate state agency, or if applicable certified under Medicare. Out-of-state practitioners must be licensed and currently registered by the appropriate agency in their state and they must provide documentation that they participate in that state’s Medicaid and/or CHIP program. To be eligible to enroll, practitioners in Pennsylvania must be licensed and currently registered by the appropriate state agency. In order for providers to participate with the Department of Human Services, they must first enroll. Medical Assistance (MA) and Children's Health Insurance Program (CHIP) On-line Provider Enrollment Application
455 SANITARIUM RD WASHINGTON PA FULL
Please take advantage of online training to use the system to its full advantage. The Commonwealth of Pennsylvania Department of Human Services offers state of the art technology with PROMISe™, the claims processing, provider enrollment, and user management information system.
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