Provider Enrollment   Skip portlet
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Become a Provider
To become an enrolled provider for the Alaska Medical Assistance Program, please complete an online application using one of the links below.

An incorporated business entity (such as C-Corporation, S-Corporation, LLC) will select Group Provider Enrollment. This enrollment type will grant billing privileges and allow affiliation with individually rendering service providers.

Individuals rendering health care services (physicians, therapists, personal care assistants) will select Individual Provider Enrollment. These providers typically render services, are affiliated to a group and are paid by their employer. These individual providers do not have billing privileges.

A sole proprietorship is an unincorporated business controlled by an individual owner who is personally responsible for the business's profits, losses, lawsuits and liabilities. A sole proprietor provides a health care service and has billing privileges. To enroll as a sole proprietor select Individual Provider Enrollment. Answer yes to the question "Do you bill claims that will be paid and reported under your SSN/ITIN?" If a person enrolled as a sole proprietor later decides to incorporate, a Federal Tax Identification number, a new group enrollment and a new enrollment fee are required.

For more information about enrollment see the FAQs and Instructions. If you have any questions regarding the application process or are not able to complete the application, please contact Conduent Provider Enrollment at AK-Enrollment@Conduent.com, include your application number and contact information.

Group Provider Enrollment
Become a Trading Partner
If you would like to become a Trading Partner (EDI) to exchange business information electronically with the Alaska Medical Assistance Program, you can do so by completing an application online. If you have any questions regarding the application process or are not able to complete the online application, please contact Conduent Provider Enrollment Unit at (800) 770-5650 or (907) 644-6800 during business hours from Monday to Friday, 8:00 AM - 5:00 PM AKST.
Application Status
To check the status of your Alaska Medical Assistance Program or Trading Partner Application, use your Application Tracking # and click the SUBMIT button.
  
Recall Provider Application
To recall an application that you have partially completed, enter your Application Tracking Number, and SSN / FEIN and click the SUBMIT button.




Recall Trading Partner Application
To recall an application that you have partially completed, enter your Application Tracking Number and SSN / FEIN and click the SUBMIT button.




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