Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form - California

Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form - California

Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form is a legal document that was released by the California Department of Health Care Services - a government authority operating within California.

FAQ

Q: What is the Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form?
A: The form used by healthcare providers in California to participate in the Gemt Supplemental Reimbursement Program for Medi-Cal Ground Emergency Medical Transportation Services.

Q: Who uses the Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form?
A: Healthcare providers in California that offer Medi-Cal Ground Emergency Medical Transportation Services and want to participate in the Gemt Supplemental Reimbursement Program.

Q: What is the purpose of the Gemt Supplemental Reimbursement Program?
A: The program provides additional reimbursement to healthcare providers for providing ground emergency medical transportation services to Medi-Cal patients.

Q: What information is required on the Provider Participation Agreement Form?
A: The form requires provider information, service location details, and an agreement to comply with program requirements.

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Form Details:

  • The latest edition currently provided by the California Department of Health Care Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Medi-Cal Ground Emergency Medical Transportation Services (Gemt) Supplemental Reimbursement Program Provider Participation Agreement Form - California

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