How to Obtain a Medicaid Provider Number

The U.S. Department of Health and Human Services issues Medicaid provider numbers through state health and human services agencies. For instance, if you are a physician in Florida, you must apply for a Florida Medicaid provider number through the Florida Agency for Health Care Administration. Provider numbers represent unique forms of identification. You do not need a number if you will not provide health-related services to Medicaid recipients.

Instructions:

1.       Determine if you are eligible to receive a provider number. For instance, if you are a dentist licensed in New Zealand, you first must obtain authorization to provide dental care in the United States. If you recently have graduated from medical school in the U.S., you need a medical license before you can treat anyone, including Medicaid recipients.

2.      Contact the appropriate health and human services agency and obtain an official application, which usually is available for free through the agency's website. For instance, New York's Department of Health maintains a comprehensive Medicaid provider manual.

3.      Gather such relevant information as your tax identification number, usually your social security number or federal employer identifier number. You must disclose a physical address and phone number to identify your business. If you distribute medical equipment, you need to identify your company's legal name that is registered with your state's secretary of state.

4.      Complete a fingerprint card so that your criminal history can be reviewed, if requested. Some states exempt non-profit or government organizations, such as nursing homes or hospitals, from fingerprint requirements.

5.      Select a reimbursement method. You will not receive money immediately after rendering services, such as through a patient's co-pay. You can either receive payment electronically or file an exception request. To qualify for electronic fund transfers, you must provide your bank account number and routing information.

Tips & Warnings:

• Provider applications often request information about past disciplinary actions. For instance, you must disclose if you were sued for medical malpractice in another state or previously were excluded from receiving a provider number.

 

• Be wary of scam artists who charge high fees to submit provider applications. Procedures throughout the U.S. are simplified so that anyone easily can file a complete application.