Washington Out of Country Provider Application

State:
Washington
Control #:
WA-SKU-3780
Format:
PDF
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Description

Out of Country Provider Application Washington Out of Country Provider Application is a form that must be completed by medical providers located outside of Washington State, in order to be eligible for reimbursement from Washington State Medicaid. This form is required for all providers of medical services, such as physicians, hospitals, pharmacies, and other medical service providers. The Washington Out of Country Provider Application is used to ensure that all providers meet the necessary requirements to be eligible for reimbursement and to help verify the provider’s credentials. There are three types of Washington Out of Country Provider Application: the General Provider Application, the Out-of-Country Provider Application, and the Provider Reimbursement Application. The General Provider Application must be completed by providers seeking reimbursement for services provided in the United States. The Out-of-Country Provider Application must be completed by providers seeking reimbursement for services provided outside the United States. The Provider Reimbursement Application must be completed by providers seeking reimbursement for services provided in both the United States and outside the United States.

Washington Out of Country Provider Application is a form that must be completed by medical providers located outside of Washington State, in order to be eligible for reimbursement from Washington State Medicaid. This form is required for all providers of medical services, such as physicians, hospitals, pharmacies, and other medical service providers. The Washington Out of Country Provider Application is used to ensure that all providers meet the necessary requirements to be eligible for reimbursement and to help verify the provider’s credentials. There are three types of Washington Out of Country Provider Application: the General Provider Application, the Out-of-Country Provider Application, and the Provider Reimbursement Application. The General Provider Application must be completed by providers seeking reimbursement for services provided in the United States. The Out-of-Country Provider Application must be completed by providers seeking reimbursement for services provided outside the United States. The Provider Reimbursement Application must be completed by providers seeking reimbursement for services provided in both the United States and outside the United States.

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Washington Out of Country Provider Application