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This version of the form is not currently in use and is provided for reference only. Download this version of
BFA Form 777
for the current year.
BFA Form 777 Nh Easy Provider Enrollment - New Hampshire
What Is BFA Form 777?
This is a legal form that was released by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is BFA Form 777?A: BFA Form 777 is a form used for provider enrollment in the New Hampshire Medicaid program.
Q: Who uses BFA Form 777?A: BFA Form 777 is used by healthcare providers who wish to enroll in the New Hampshire Medicaid program.
Q: What information is required on BFA Form 777?A: BFA Form 777 requires providers to provide basic information about their practice, such as their contact information and the services they offer.
Q: Are there any fees associated with provider enrollment?A: There are no fees associated with provider enrollment in the New Hampshire Medicaid program.
Q: How long does the enrollment process take?A: The enrollment process can take several weeks to complete, depending on the accuracy and completeness of the application.
Form Details:
- Released on May 1, 2023;
- The latest edition provided by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of BFA Form 777 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance.
Download BFA Form 777 Nh Easy Provider Enrollment - New Hampshire
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