Maryland medicaid adjustment request form 2026

1. Click ‘Get Form’ to open the Maryland Medicaid Adjustment Request Form in the editor.
2. Begin by entering your provider information in the designated fields. Ensure that your National Provider Identifier (NPI) is accurately included, as this is crucial for processing.
3. In the section for claim details, provide the original claim number and specify the reason for the adjustment request. Be clear and concise to avoid any confusion.
4. Attach any necessary supporting documentation, such as remittance advices or previous claims, directly within our platform to streamline submission.
5. Review all entered information for accuracy before submitting. Utilize our platform's features to check for any errors or missing fields.
6. Once everything is confirmed, click ‘Submit’ to send your adjustment request directly to the Medical Assistance Adjustment Unit.

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