The 2025 Medicaid DMAP revalidation period has begun, and a portion of the EOCCO network has been identified for revalidation. In the coming days and weeks, we will be reaching out to providers on our revalidation list.
If you enrolled or re-enrolled in 2024, you likely will not appear on this list. For those who do, we will require completed forms and accompanying documentation, such as individual practitioner licensure or clinic/group W-9s.
Action items for all active EOCCO providers:
- Please check this page to find/enter your NPI to see if an individual provider or clinic needs to be revalidated: Provider DMAP Revalidation Lookup
- If yes, please “Instructions to revalidate” section below
- If no, you may disregard the remainder of this message unless we contact you directly
- If you are still unsure whether you need to complete this process, feel free to contact us at providerDMAPApps@modahealth.com. When emailing us, please use the subject line “2025 Medicaid DMAP Revalidation” so we may properly expedite your emails/applications.
Instructions to revalidate:
Please complete the following documents and email them to providerDMAPApps@modahealth.com with the subject line “2025 Medicaid DMAP Revalidation” so we may properly expedite your emails/applications.
For individual practitioners or providers
- Please fill out and return the document titled “OHA DMAP individual all documents combined” When returning the completed application please attach a PDF copy of your active licensure for the state your practice is located. (Ex. If your clinic primary address is in Boise, submit your Idaho license.)
For Clinics/Facilities only
- Please fill out and return the attached titled “OHA DMAP group-facility all documents combined” when returning the completed application please attach a PDF copy of your group/clinic W9.
Important notes:
- The deadline for revalidation is March 31, 2025.
- If revalidation is not completed by this date, claims may begin to deny due to a lack of DMAP registration.
- If this occurs, contact us immediately so we can assist with re-enrollment, backdate your registration, and reprocess claims.
We appreciate your patience as we work to make this process as seamless as possible for everyone involved.
