New Hampshire Network Management Systems Agreement

State:
Multi-State
Control #:
US-CP1026-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Network Management Systems Agreement document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

NH Medicaid (Medical Assistance) is a federal and state funded health care program that serves a wide range of individuals and families who meet certain eligibility requirements.

You can call the NH Medicaid Provider Relations Call Center at 1-866-291-1674 or 603-223- 4774, Mon ? Fri, from AM to PM and they can tell you if a provider is enrolled in NH Medicaid.

NH Medicaid Provider Enrollment To enroll as a NH Medicaid provider, visit the New Hampshire MMIS Health Enterprise Portal and click on Provider in the upper left of the page.

NH Healthy Families provides the same benefits as Medicaid, plus more. In this section, you can learn about the health benefits, pharmacy services and value added services NH Healthy Families offers. Need help understanding these benefits and services? Call us at 1-866-769-3085 (TDD/TTY 1-855-742-0123).

Non-participating providers must submit Prior Authorization for all services. For non-participating providers, Join Our Network. Urine Drug Screens rendered by MAT (Medication Assisted Treatment) providers require notification only. Prior auth is not required.

To request disenrollment from your plan, call or write to NH DHHS. Contact the NH DHHS Customer Service Center at 1-844-ASK-DHHS (1-844-275-3447) (TDD Access Relay: 1-800-735-2964), Monday through Friday, 8 a.m. ? 4 p.m. ET.

Contact the DHHS Customer Service Center toll-free at 1-844-ASK-DHHS (1-844-275-3447) (TDD Relay Access: 1-800-735-2964), Monday through Friday, a.m. to p.m. ET.

Who is eligible for New Hampshire Medicaid? Household Size*Maximum Income Level (Per Year)2$26,2283$33,0644$39,9005$46,7374 more rows

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New Hampshire Network Management Systems Agreement