Contact Lisa Oberg at 402.881.1452 for questions or updates.
Contractor Enrollment Process Document
2023 Contractor Vendor Approval Process.pdf
Attachments
Attachment A 2023 Contractor Packet Intro Email.docx
Attachment B 2023 Contractor Packet Into Letter.doc
Attachment C 2023 Contractor Zoom Meeting Confirmation Email.docx
Attachment D 2023 Annual Bkgd Check Request Email.docx
Attachment E 2023 Annual Bkgd Check Request Letter.doc
Attachment F 2023 5 yr Renewal Request Email.docx
Attachment G 2023 5 yr Renewal Request Letter.doc
Attachment H 2023 Contractor Initial Welcome Letter.doc
Attachment I 2023 Contractor 5 yr Revalidation Approval Letter.doc
Attachment J 2023 Contractor Ineligible Letter_Criminal Convictions.doc
Attachment K 2023 Contractor Ineligible Revalidation Email.docx
Attachment L 2023 Contractor Ineligible Revalidation Letter.doc
Attachment M 2023 Contractor Guide.docx
Attachment N NEnewhire test.pdf
Contractor Enrollment Documents
1_2022 Contractor_Vendor Information Form.pdf
2_Nebraska DOL Contractor Registration.pdf
3_MC199Provider Release of Info_Felony_Misdemeanor Statement.pdf
4_MLTC62N Nebraska Ownership_Controlling Interest and Conviction Disclosure.pdf
6_ MC-19Nebraska Service Provider Agreement.pdf
6_MC19Inst Nebraska Service Provider Agreement Instructions.pdf
2023 ATP Contractor Vendor Enrollment Guide Medicaid Forms.pdf
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