Form SFN615 Medicaid Program Provider Agreement - North Dakota

What Is Form SFN615?

This is a legal form that was released by the North Dakota Department of Health and Human Services - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the SFN615 Medicaid Program Provider Agreement?A: The SFN615 Medicaid Program Provider Agreement is a form used in North Dakota for healthcare providers to enter into an agreement with the Medicaid program.

Q: Who needs to complete the SFN615 Medicaid Program Provider Agreement?A: Healthcare providers who wish to participate in the Medicaid program in North Dakota need to complete the SFN615 Medicaid Program Provider Agreement.

Q: What information is required on the SFN615 Medicaid Program Provider Agreement?A: The SFN615 Medicaid Program Provider Agreement requires information such as the provider's name, contact information, services offered, and agreement to abide by Medicaid program rules and regulations.

Q: Is there a fee to submit the SFN615 Medicaid Program Provider Agreement?A: No, there is no fee to submit the SFN615 Medicaid Program Provider Agreement.

Q: Can providers terminate their agreement with the Medicaid program?A: Yes, providers can terminate their agreement with the Medicaid program by providing written notice to the Medicaid program office.

Q: What happens after submitting the SFN615 Medicaid Program Provider Agreement?A: After submitting the SFN615 Medicaid Program Provider Agreement, the provider's application will be reviewed, and if approved, they will be enrolled as a Medicaid provider.

Q: How long does it take to get approved as a Medicaid provider after submitting the SFN615 Medicaid Program Provider Agreement?A: The timeframe for approval as a Medicaid provider after submitting the SFN615 Medicaid Program Provider Agreement can vary, but it typically takes a few weeks to process the application.