Home
Forms Library
CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE

CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE 2026

CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE Preview on Page 1

See details

4 out of 5

31 votes

The DMAP Provider Contract outlines the agreement between the State of Delaware's Department of Health and Social Services and providers delivering services to eligible individuals under the Delaware Medical Assistance Program (DMAP). It details the provider's obligations regarding compliance with laws, licensure, payment processes, record retention, non-discrimination, liability, and dispute resolution. The contract emphasizes adherence to DMAP regulations and stipulates conditions for reimbursement, penalties for non-compliance, and procedures for termination or amendment of the contract.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering your name and title in the designated fields on the signature page. Ensure that all information is legible.
Review the 'Applicable Laws and Regulations' section carefully. Acknowledge your agreement by checking any required boxes if applicable.
Fill out the 'Licensure' section, confirming that you possess the necessary licenses and certifications to provide services under this contract.
In the 'Payment for Items or Services' section, ensure you understand the billing requirements. Fill in any relevant details regarding payment claims.
Complete any additional sections as required, such as 'Retention and Disclosure of Records' and 'Eligibility', ensuring compliance with DMAP policies.
Finally, review all entries for accuracy before signing. Once satisfied, sign and date the document at the bottom of the page.

Start using our platform today to streamline your document editing and signing process for free!

See more CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE versions

We've got more versions of the CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE form. Select the right CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2015	4 Satisfied (31 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I use Delaware Medicaid out of state?

One cannot transfer their Medicaid benefits from one state to another state, nor can they receive Medicaid benefits simultaneously in two states. Instead, one must close their Medicaid case, and hence their benefits, in their original state, and then reapply for Medicaid in the state to which they are relocating.

What does Medicaid in Delaware cover?

Medicaid pays for: doctor visits, hospital care, labs, prescription drugs, transportation, routine shots for children, mental health and substance abuse services.

What documentation is required for Medicaid in Delaware?

You will need to provide verification of your income. You do not need to provide proof of your assets or resources (bank accounts, cars, stocks, etc.) or come into our offices to be interviewed unless you are applying for one of the Long Term Care Medicaid programs or Home and Community Based Services).

Does Medicaid pay for glasses in Delaware?

Adults and children may get contacts or glasses and an eye exam with no copay once a year.

What is the state of Delaware medical assistance program?

Medicaid furnishes medical assistance to eligible low-income families and to eligible aged, blind and/or disabled people whose income is insufficient to meet the cost of necessary medical services.

Does Delaware Medicaid pay for dental?

ADULT ORAL HEALTH/TIPS Highmark Health Options Delaware Medicaid covers dental care for adults 21 and older. Evolve Delaware Medicaid covers dental for adults 21 and older.

How to apply for medical assistance in Delaware?

To apply online visit and click on Apply for Benefits. To download and print an application, click here. For application assistance, contact the Customer Relations Unit at 1-800-372-2022.

CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE 2026

Here's how it works

How to use or fill out CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE

See more CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE versions

Complete this form in 5 minutes or less

Got questions?

Can I use Delaware Medicaid out of state?

What does Medicaid in Delaware cover?

What documentation is required for Medicaid in Delaware?

Does Medicaid pay for glasses in Delaware?

What is the state of Delaware medical assistance program?

People also ask

Does Delaware Medicaid pay for dental?

How to apply for medical assistance in Delaware?

Related links

Try more PDF tools

CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE 2026

Here's how it works

How to use or fill out CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE

See more CONTRACT FOR ITEMS OR SERVICES DELAWARE MEDICAL ASSISTANCE versions

Complete this form in 5 minutes or less

Got questions?

Can I use Delaware Medicaid out of state?

What does Medicaid in Delaware cover?

What documentation is required for Medicaid in Delaware?

Does Medicaid pay for glasses in Delaware?

What is the state of Delaware medical assistance program?

Related Searches

People also ask

Does Delaware Medicaid pay for dental?

How to apply for medical assistance in Delaware?

Related links

Try more PDF tools