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Medicaid Caqh Form: What You Should Know

If you are already registered with Molina Healthcare please provide your new CASH number when completing this form.  To complete a CASH Provider Data Form for Molina Healthcare, please  provide: Full name Social Security Number Mail to: Molina Healthcare 1 Corporate Drive  Suite 203 Molina Healthcare of Ohio (Healthcare Partners)  4555 North High Street Cincinnati, Ohio 45210 USA CASH Provider Data Form. For Credentialing Purposes. Date: Are you registered with CASH (requirement)? Drug Enforcement Agency (DEA)  U.S. Code Title 26, Section 1302 Provider Identification Number.  All Health Care Providers, including Medical Group (MD, DO) This forms is for use with Molina Healthcare Group in  Massachusetts as of May 13, 2017. We are expanding the application process for physicians licensed  out of state. We apologize for any inconvenience this may cause. This form should be completed once a year and will be valid for the 2024 calendar year,  until January 1, 2019. If you need to update your information or have questions please contact  a member of HIRES at  For more information on a provider's eligibility check the “Exemption Information” area  on CASH Provider Data Form for an additional cost.  (See CLASS — Customer Account Names area)  If you do not have a Social Security or Medicare Card or a valid state health insurance card  You will not be able to complete this form. Please print this form and keep it in a safe place as it is a mandatory requirement to  register as an individual. If you would like to know your eligibility check the “Exemption Information” area  on CASH Provider Data Form for an additional cost.  For more information on a provider's eligibility check the “Exemption Information”  area on CASH Provider Data Form for an additional cost.  This is the name and current phone number of the customer account service agent at  CASH Provider Data Form for Medicare Part B. This form should be completed once a year and will be valid for the 2024 calendar year, until January 1, 2019.

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Video instructions and help with filling out and completing Medicaid Caqh

Instructions and Help about Medicaid Caqh

Good day, everyone! My name is Dhruv and I am the Senior Project and Outreach at CA QH Core. It is my pleasure to welcome you today to our webinar on electronic healthcare attachments, the second webinar in a four-part series. In today's webinar, we will focus on pilot and implementation case studies. Before we begin, I would like to mention a few logistical items. You can download a copy of today's presentation from the CA QH org website. Navigate to the Core pulldown menu at the top of the CA QH org welcome screen and select the Core Education Events page. A link to the PDF version of the presentation can be found under the listing for today's webinar. Additionally, a copy of the slides, as well as the webinar recording, will be emailed to all attendees and registrants in the next 1 to 2 business days. We will save time at the end of today's program to respond to audience questions, and you are encouraged to submit your questions at any time during the webinar by typing them into the Questions panel on your dashboard. We do ask that when you submit your question, please identify the type of organization you are with so that we can give you a more applicable response. We would like to thank our partners for joining us today. Joining us, we have Lea Altschuler, President and CEO of Lantana Consulting Group, Mary Lynn Bushman, Senior Business Analyst with National Government Services, and Nicole Smith, Vice President of Operations and Government Services with Vine Corporation. Our session today will start with an overview of CA QH Core's work on attachments. Before we move into why electronic attachments are needed, we will then learn about the different case studies being presented. And then we will finish off with...