Alaska Medicaid Provider Revalidation
Welcome to the Alaska Medicaid Provider Revalidation portal. The revalidation application and any required addendums are accessed from this page.
Please note that we cannot accept handwritten revalidation applications; download the form(s) onto your computer for completion. Complete, sign and return the revalidation application and required addendums to:
Conduent State HealthCare
PO Box 240808
Anchorage, AK 99524-0808
For additional information on revalidation, please review the Provider Revalidation FAQs.
For information on the application fee, please review the Provider Application Fee FAQs.
If you would like to submit a new enrollment please visit: Medicaidalaska.com.
If you would like to update an existing enrollment, please complete and submit this form: Update Provider Information Request Form.
If you need revalidation assistance, please contact: AK-Enrollment@Conduent.com.