Arkansas Application Service Provider Agreement

State:
Multi-State
Control #:
US-CP1027-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Application Service Provider 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

Update your information with AR Medicaid You can update your information on the phone, online, or in person: Call the Renew Arkansas hotline at 1-844-872-2660. Go online at access.arkansas.gov. Visit your local DHS county office to update your information.

If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at 501-376-2211 or 1-800-457-4454 toll-free.

Other Important Numbers Arkansas Medicaid Claims Questions Information Line (coverage, bills, beneficiary denial letters, or other services)1-800-482-5431Arkansas Medicaid Complaint Hotline (for complaints about healthcare)1-888-987-12002 more rows

You may call or email the DHS County Office at the phone number or webmail address shown to report changes for your TEA, Medicaid, or SNAP case(s). Please use the toll-free number provided if the DHS County Office number is long distance. Is this a new address?

To appeal, you must send a letter to DHS requesting an administrative hearing. You should have gotten a letter that told you about this decision. You must send your request for a hearing letter within 30 calendar days of the date on the letter (90 days for SNAP) or your request will be denied.

The Toll-Free Telephone Helpline, 1-800-275-1131, operates Monday through Friday am to pm. ConnectCare Helpline Specialists assign or change PCPs at the request of Medicaid and ARKids First beneficiaries.

How can I become an Arkansas Medicaid provider? To enroll as an Arkansas Medicaid provider, go the the online enrollment application. When applying online, there is less possibility for making errors that would result in your application being denied and returned to you for correction.

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Arkansas Application Service Provider Agreement