Medicaid Provider Numbers and MCO Provider Numbers

Q:        Do I need a Medicaid Provider Number and how do I get one?

A:        Yes, you will need to have a Medicaid Provider Number to access the DHMH Eligibility Verification System (EVS).  EVS will provide information on whether individuals you are serving are currently enrolled in PAC or Medicaid.  To get a Medicaid Provider Number, you need to complete and mail in an application.  DHMH recently mailed provider applications with special instructions for substance abuse providers to all OHCQ-certified providers who do not have a Medicaid provider number.  If you need a provider application, contact Susan Harrison in the DHMH Office of Health Services at .   You will need to attach your OHCQ certification form.  You will need to sign the attestations, as well as the attached contract.  An accurately completed application takes about 3 to 4 weeks to process.     

Q:        How do I get a Medicaid Provider Number if my OHCQ certification is not current?

A:        The Office of Health Care Quality (OHCQ) is currently running behind schedule on renewals for OHCQ-certified addictions providers.   If you are a provider that has timely submitted an application for renewal with OHCQ, but it has not occurred for reasons of administrative delay (not concerns about quality of services), you can request a letter from OHCQ that states that you are a provider in good standing.   This letter should be included in your application for a Medicaid provider number.