You receive the Submit Complete page when you have submitted your application successfully. It provides an application tracking number to be used when you are checking on the status of your application. You can print, upload, and mail any required documents. All signed enrollment documents and additional information should be sent to the address indicated.
The Submit Complete page contains the following panels and options:
| Field | Description |
|---|---|
| Application Tracking Number |
Number assigned to individual or group application. It is required when you check the status of your application either by phone or via the Web. It should also be written on all documents that are mailed in to support your application. |
| Trading Partner Application Tracking Number |
Displayed only if vendor software information was completed on the Electronic Transaction Submission page. The number assigned to the trading partner application. It should also be written on all documents that are mailed in to support your application. Note: This field is displayed only when the provider chooses Vendor Software on the Electronic Claims Submission page and the trading partner tables are populated with the Provider's information. |
| Links | Description |
|---|---|
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Print Required Documents Print, complete, upload (as an attachment) and mail the documents listed to the address indicated on the page. The list of documents depends on the type of application being submitted. |
|
| Attachment Placeholder |
Indicates a document needed to print, complete, upload and mail to complete the enrollment process. Some examples may include an enrollment signature page or CLIA certification. |
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To print a copy of the entire application you entered for your records, click Print Application. To exit the application and return to the Provider Enrollment Home page, click Exit Application. |
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| Field | Description |
|---|---|
| To add an attachment, in the Attachments panel, click Add Attachment. Existing attachments are displayed in the table. To save all attachments, in the Attachments panel, click Save All Attachments. | |
| Date Added |
The date the attachment was added. |
| Added by |
The name of the person who added the attachment. |
| File Name | The file name of the attachment. |
| Description | The attachment description. |
| Once all of the required documents have been printed or uploaded, click the Exit Application button to return to the Alaska Medical Assistance Provider Enrollment Homepage. | Indicator that you are directed to the Provider Enrollment home page upon exiting the application. |
Version as of 6/30/2015.
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