Pennsylvania Application Service Provider Agreement
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How to fill out Application Service Provider Agreement?
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FAQ
?Enrollment Information. In order for providers to participate with the Department of Human Services (DHS), they must first enroll. To be eligible to enroll, practitioners in Pennsylvania must be licensed and currently registered by the appropriate state agency.
Typically it takes up to 30 days to get a decision once a Medical Assistance (MA) application is submitted. However, if the applicant is experiencing a medical emergency, the County Assistance Office (CAO) can speed up the proceeding of the application.
As a Medicaid consumer, you have the right to choose your Managed care plan based on the health plans available in your area, and you have the right to switch plans at any time. To choose or change your plan, visit .enrollnow.net or call PA Enrollment Services at 1-800-440-3989 (TTY 1-800-618-4225).
Q: WHAT IS THE PROMISe ID? A: The PROMISe, or Provider Reimbursement and Operations Management Information System, ID is an identification number issued by the Pennsylvania Department of Human Services (Department or DHS).
Income & Asset Limits for Eligibility 2023 Pennsylvania Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleIncome LimitAsset LimitInstitutional / Nursing Home Medicaid$2,742 / month*$2,000?Medicaid Waivers / Home and Community Based Services$2,742 / month?$2,000?1 more row ?
The Bureau of Managed Care Operations is responsible for the administration and oversight of mandatory managed care program known as HealthChoices that provides Medical Assistance benefits to eligible recipients in Pennsylvania.
You will also be required to provide proof of identity (such as a driver's license or state identification card), a Social Security Number (SSN), proof of residency in the state of Pennsylvania, proof of United States citizenship (some exceptions may apply), and information on your household composition.