AK Form 8484 2017-2024

AK Form 8484: What You Should Know

For Alaska, PPS is a means to determine whether a patient qualifies for professional fees/reimbursement for services performed. 21.3.11 Medical Exam Fees — Alaska Division of the Revenue Alaska uses Daylight Saving Time. Refer to the Alaska Division of Taxation website for the Alaska Department of Revenue (ADR) website about the Medical Fee Determination process for medical fees. This includes fees charged through a fee-for-service health plan (including Medicaid). 21.3.12 Medical Examination — ADR Alaska Division of the Revenue In general, you will not be considered a candidate for medical appointment if you do not have a license issued by the state. All medical examinations must be completed at an Arizona Department of Regulatory Agencies-approved medical exam site. 21.3.13 Residence Reasonable Allowance for Travel Expenses — ADR Alaska Division of Taxation In general, you will not be considered a candidate for medical appointment if you do not have a license issued by the state. All medical examinations must be completed at an Arizona Department of Regulatory Agencies-approved medical exam site. 21.3.14 Application to Change Address or Contact Fax — ADR Alaska Division of the (ADR) You cannot be a candidate for appointment in Alaska if you are ineligible because of your current address or a mailing address. In addition, you cannot be a candidate for appointment in Alaska if you apply for the same appointment or a new appointment by fax or email. The following information should be provided when you apply for your first medical appointment. Incomplete information will be received as “No further action.” There is no requirement for a completed application or any application information to be filed with the Alaska Department of Revenue (ADR). If you apply to a new medical examiner, you must re-file your application. There is a charge of 4 upon filing the application for all new medical examiner applications. 21.3.15 Applicant Education and Experience Requirements To apply for an appointment you must have held the position for two years or more. Please keep this information current; we will update each year. You are required to complete a background check and a criminal history check and meet all other qualifications to be a candidate for medical appointment, based on the following information.

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