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COMMONWEALTH of VIRGINIA Department of Medical Assistance Services CYNTHIA JONES DMS DIRECTOR SUITE 1300 600 EAST BROAD STREET RICHMOND, VA 23219 804/786/7933 800/343-0634 (TDD) www.dmas.virginia.gov

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What is fax cover - dmas?

Fax cover - dmas is a form used to submit information to the Department of Medical Assistance Services (DMAS) via fax.

Who is required to file fax cover - dmas?

Healthcare providers and facilities that are enrolled in Medicaid and need to submit information to DMAS are required to file fax cover - dmas.

How to fill out fax cover - dmas?

Fax cover - dmas can be filled out by providing the required information such as patient details, provider information, and reason for submission.

What is the purpose of fax cover - dmas?

The purpose of fax cover - dmas is to facilitate the submission of information to DMAS in a secure and organized manner.

What information must be reported on fax cover - dmas?

Information such as patient demographics, diagnosis codes, provider NPI number, and details of the submitted documents must be reported on fax cover - dmas.

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