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  • Promise Provider Enrollment Base Application

Get Promise Provider Enrollment Base Application

INSTRUCTIONS FOR COMPLETION OF PENNSYLVANIA PROMISe PROVIDER ENROLLMENT DME APPLICATION Applications must be typed or completed in black ink, or they will not be accepted. Applications will be scanned.

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It provides for grants of at least $1,000 per year for community college students for two years and a minimum of $2,500 per year for four years to Pennsylvania State System of Higher Education Schools and state related institutions.

Telephone: Call the Consumer Service Center for Health Care Coverage at 1-866-550-4355. In-Person: You can contact your local county assistance office (CAO).

Alternatively, you may also contact the Provider Service Center at 1-800-537-8862 to inquire on the status of claims.

Using a touch-tone phone, please call 1-800-766-5387. The PROMISeâ„¢ Eligibility Verification System (EVS) enables you to determine a participant's Medical Assistance eligibility, as well as the participant's scope of coverage.

Typically it takes up to 30 days to get a decision once a Medical Assistance (MA) application is submitted. However, if the applicant is experiencing a medical emergency, the County Assistance Office (CAO) can speed up the proceeding of the application.

Enrollment Status. Enter your assigned Tracking number and Federal Tax Indentification Number (TIN or EIN) that you used for your enrollment to verify the current status of your enrollment application. For any further queries, please contact Provider enrollment at 1-800-457-4584.

Allegheny College will cover the full cost of tuition for students whose families earn a total annual income of $50,000 or less.

Alternatively, you may also contact the Provider Service Center at 1-800-537-8862 to inquire on the status of claims.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232