Provider Resources


The menu options on this page allow you to download current banner messages that have been included in the providers' Medicaid remittance advices and various state and federal documents and forms.

Provider Resources
Provider Enrollment Requests

  • Enrollment Forms

  • To enroll as a new provider, submit an application through Alaska Medicaid Provider Enrollment Portal.

    For information on submitting documents needed to support your enrollment applications, consult the Provider Enrollment Document Submission Job Aid

    Enrolled Provider Resources

  • Billing Manuals
  • Messages & Announcements
  • Provider FAQ


    Providers who choose to provide services prior to becoming approved for enrollment run the risk of not being reimbursed for services. Provider Enrollment will be approved upon the completion of all risk-based screening as outlined in the Affordable Care Act under 42 CFR § 455.450. Retroactive enrollments will not be granted unless there is proof of an extenuating circumstance. These circumstances include emergency medical access, prior authorization, and concurrent enrollment with Medicare or another state’s Medicaid program.

    If you believe your request falls within one of these categories, you may supply the state with an explanation as to how you qualify under one of these circumstances and provide supporting documentation for additional review. If you wish for the state to review your request for possible backdate of your enrollment, please fill out the Request to Backdate Provider Enrollment form and submit it to Conduent for review by DHCS.