Provider Maintenance Form · 7KH SURJUHVVLRQ DUURZ DW WKH WRS RI WKH SDJH GLVSOD\V WKH SURJUHVV RI...

1

Provider Maintenance Form

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 1

2

Provider Maintenance Form PMF

PMF

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 2

3

Provider Agreement

W-9

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 3

4

PMF

PMF

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 4

5

PMF

PMF

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 5

6

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 6

7

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 7

8

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 8

9

Provider Agreement

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 9

10

General Information

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 10

11

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 11

12

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 12

13

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 13

14

.

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 14

15

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 15

16

General InformationPlease make note of this reference number should there be a need to contact us regarding this request.

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 16

17

Take precautions to ensure these notifications don’t get caught in your SPAM/Junk email bucket.

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 17

18

General Information

General Information

Back to Selected Updates Page

General Information

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 18

19

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 19

20

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 20

21

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 21

22

You have requested to update a record that requires supporting documentation. Please upload documents using the Attachments section above

oo

System unavailable, please try again later

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 22

23

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 23

Anthem Kentucky Managed Care Plan, Inc. (Anthem) Attachment C.6.a-1. Provider Maintenance Form Training Guide

Medicaid Managed Care Organization (MCO) - All Regions RFP 758 2000000202

Attachment C.6.a-1 — Page 24