"Participation Agreement Form and Variations" is a American Lawyer Media form. This is a participation agreement form with different variations.
Oklahoma Participation Agreement Form and Variations
State:
Multi-State
Control #:
US-PA197
Format:
Word;
PDF;
Rich Text
Instant download
Description
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How to fill out Participation Agreement Form And Variations?
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These can include a U.S. passport, certificate of citizenship or certificate of naturalization, or birth certificate showing U.S. birthplace or its territories (for citizenship) and a driver's license (for identity). (See SoonerCare Citizenship Fact Sheet for a detailed list of acceptable proof.)
Member or Applicant with questions about SoonerCare? For assistance with the Online SoonerCare Application or other questions or concerns about SoonerCare, please call the SoonerCare Helpline at 800-987-7767.
In 2021, SB574 created the Oklahoma State Health Information Network Exchange (OKSHINE). Last year, the Oklahoma Legislature passed SB 1369, expanding healthcare provider requirements to access and transmit certain types of patient information via OKSHINE.
CHANGE OF OWNERSHIP 1. Obtain re-certification as a title XVIII (Medicare) facility under the new ownership, if applicable. 2. Complete new Medicaid provider enrollment packets for each provider number affected by the Change of Ownership.
First-time applicants can use the online application to complete an enrollment application and sign a provider contract. Providers who are already enrolled in the SoonerCare Provider program can renew their contract online. They can also: Complete a saved application.
The OKDHSLive! web site is an easy way to see if you might be eligible for Food Benefits or SoonerCare Medicaid. You may also use this web site to renew your eligibility for SNAP, SoonerCare or Child Care: or to request (apply for) these benefits.