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Plaaslike Owerheid / Local Authority Voltooi asseblief in swart ink / Please complete in black ink LET WEL: Aansoekers word gemaan om nie hul huidige werkgewer kennis van diensbe indiging te gee nie.

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Assigning Medicaid IDs to administer PNM module accounts – Call the Ohio Medicaid Integrated Help Desk at 1-800-686-1516 and select option 2, and then select option 3 to speak to a live agent. Call representatives will confirm provider credentials prior to updating the system. A call-back option is available.

After you have entered your basic demographic information, the system will issue you an Application Tracking Number (ATN). You should record this ATN immediately, because it will serve as your secure key to return to your application or to track it through the enrollment process.

In Ohio, you can register as a transportation provider if you provide the state's medicaid office with documentation, such as your driver's license; a vehicle maintenance report; and a written backup plan in the event that your vehicle breaks down. You also have to pass a drug screening and a competency test.

To become a Medicaid waiver provider in Ohio call (800) 617-6733 for instructions. Persons or agencies who provide services to individuals with developmental disabilities must obtain certification from the Ohio Department of Developmental Disabilities.

You can get a ride to: Any provider visit or health care appointment. The local Women, Infants and Children (WIC) office. A pharmacy to pick up prescriptions.

All in-patient services require prior authorization. Please call 1-800-488-0134Navigate to tel:1-833-230-2101Navigate to tel:1-833-230-2101Navigate to tel:1-833-230-2101 to obtain prior authorization for emergency admissions. Outpatient emergency services do not require prior authorization.

How can I check on the status of my application? Call our Consumer Hotline at 800-324-8680 or log in to your Ohio Benefits account here to check the status of your application.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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