Get Ny Emedny-432301 2010
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How to fill out the NY EMEDNY-432301 online
The NY EMEDNY-432301 form is essential for providers of non-institutional pediatric continuous private duty nursing services to apply for an enhanced reimbursement rate. This guide provides clear and structured steps to help you successfully complete and submit the form online.
Follow the steps to fill out the NY EMEDNY-432301 form online.
- Press the ‘Get Form’ button to obtain the NY EMEDNY-432301 form and open it in your online editor.
- Begin by selecting the appropriate box indicating whether you are a Licensed Home Care Services Agency (LHCSA) or an independently enrolled nurse. Provide your agency name, NYS license number, Medicaid provider identification number, and National Provider Identifier (NPI) in the designated fields.
- For LHCSA providers, certify that the nurses providing services are trained and experienced in caring for medically fragile pediatric patients. Ensure that the documentation is maintained for inspection upon request.
- If you are an independently enrolled nurse, provide your name, NYS license number, Medicaid provider identification number, and NPI. Then, specify your training, including completion dates for any relevant skills, such as tracheostomy care or ventilator care.
- Sign and date the form. If you are representing an agency, include the name and title of the authorized officer or employee who is certifying the information.
- Once all fields are completed, you can save the changes made to the form, download it for your records, print it out, or share it as necessary.
Complete the NY EMEDNY-432301 form online today to ensure timely processing of your enhanced rate reimbursement.
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The phone number for Medicaid providers in NY is generally 1-800-541-2831, where you can reach representatives ready to assist you. This number is crucial for those looking to explore their options or needing information under the NY EMEDNY-432301 framework. You will receive knowledgeable guidance for any Medicaid-related inquiries. Make sure to prepare your questions in advance to make the most of your call.
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