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 Form SFN615?A: Form SFN615 is the Medicaid Program Provider Agreement for North Dakota.

Q: What is the purpose of Form SFN615?A: The purpose of Form SFN615 is to establish a contractual agreement between healthcare providers and the North Dakota Medicaid Program.

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

Q: What information is required on Form SFN615?A: Form SFN615 requires information such as provider details, services offered, billing information, and agreement terms.

Q: Are there any fees associated with Form SFN615?A: There are no fees associated with completing Form SFN615.

Q: How long does it take to process Form SFN615?A: The processing time for Form SFN615 may vary, but typically it takes a few weeks to be reviewed and approved.

Q: What happens after Form SFN615 is approved?A: After Form SFN615 is approved, the healthcare provider can begin accepting Medicaid patients and billing the program for services provided.

Q: Can a provider terminate their agreement with the North Dakota Medicaid Program?A: Yes, a provider can terminate their agreement with the North Dakota Medicaid Program by submitting a written notice of termination.