WV WV-BMS-I/DD-7 Direct Support Service 2011 free printable template
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WEST VIRGINIA I/DD WAIVER DIRECT SUPPORT SERVICE LOG (To be used with Traditional and Agency with Choice Service Models) Member Name Month of Service Name Service Code Service Coordination Agency
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How to fill out WV WV-BMS-I/DD-7 Direct Support Service
01
Obtain the WV-BMS-I/DD-7 form from the West Virginia Bureau for Medical Services website or your local office.
02
Read the instructions carefully to ensure you understand the requirements.
03
Fill out the personal information section, including name, address, and contact details.
04
Provide information about your medical history and any relevant diagnoses.
05
Detail the specific Direct Support Services you are requesting.
06
Include information about your support team or caregivers.
07
Review the completed form for accuracy and completeness.
08
Submit the form to the appropriate agency or authority as directed.
Who needs WV WV-BMS-I/DD-7 Direct Support Service?
01
Individuals with intellectual or developmental disabilities who require assistance in daily living activities.
02
Families or guardians seeking support for their loved ones with disabilities.
03
Caregivers looking for state-funded support services to aid in the care of individuals with disabilities.
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What is WV WV-BMS-I/DD-7 Direct Support Service?
WV WV-BMS-I/DD-7 Direct Support Service is a form used to document and request reimbursement for direct support services provided to individuals with intellectual and developmental disabilities in West Virginia.
Who is required to file WV WV-BMS-I/DD-7 Direct Support Service?
Individuals or organizations providing direct support services to persons with intellectual and developmental disabilities in West Virginia are required to file the WV WV-BMS-I/DD-7 Direct Support Service form.
How to fill out WV WV-BMS-I/DD-7 Direct Support Service?
To fill out the WV WV-BMS-I/DD-7 Direct Support Service form, providers should accurately enter the required information such as service details, dates of service, descriptions, and the individual receiving the service, ensuring compliance with state guidelines.
What is the purpose of WV WV-BMS-I/DD-7 Direct Support Service?
The purpose of the WV WV-BMS-I/DD-7 Direct Support Service form is to ensure proper documentation of services provided to individuals with intellectual and developmental disabilities and to facilitate reimbursement for those services.
What information must be reported on WV WV-BMS-I/DD-7 Direct Support Service?
The information that must be reported on the WV WV-BMS-I/DD-7 Direct Support Service includes the provider's details, the individual's information, types of services rendered, service dates, duration of service, and any applicable billing codes.
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