Title XIX MR/DD Waiver - Provider Enrollment Registration

Before providers can submit data, either directly via the APS Web site or through EDI submission, providers must register with APS. To register, contact Diab Thomas at ddthomas@apshealthcare.com or call APS at 304-343-9663.

Title XIX MR/DD Waiver provider enrollment forms:

• Title XIX MR/DD Waiver Provider Registration
• Title XIX MR/DD Waiver Administrator Web User Request Form
• Title XIX MR/DD Waiver Service Coordinator Web User Request Form
• Title XIX MR/DD Waiver Provider Verification Document