Get the free map 813d bcctp extension form - chfs ky

To meet this need the Department of Medicaid Services DMS may grant an extension of Medicaid eligibility. Providers can locate the MAP-813D form Breast and Cervical Cancer Treatment Program Extension at http //chfs. ky. gov/dms/ bcctp.htm. The request for the extension must be initiated by the treating physician. Before a treatment period ends the physician should fax form MAP-813D to the Department for Medicaid Services at Fax 502-209-3290 to prevent any interruption in Medicaid coverage....

How to fill out map 813d bcctp extension

How to fill out map 813d bcctp extension:

1. Start by obtaining a physical copy of map 813d bcctp extension.
2. Carefully read the instructions provided with the map to understand its purpose and how to correctly fill it out.
3. Begin by entering your personal information accurately in the designated fields, such as your name, contact details, and any other required information.
4. Next, identify the specific purpose of the map and provide relevant details accordingly. This may include marking locations, routes, or any other relevant information related to the extension.
5. Use appropriate symbols, colors, or legends as instructed to represent different elements on the map.
6. Review your filled-out map 813d bcctp extension to ensure accuracy and clarity. Make any necessary corrections or adjustments before finalizing it.
7. Once completed and reviewed, submit the filled-out map according to the specified instructions or guidelines provided.

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What is map 813d bcctp extension?

The map 813d bcctp extension is an extension that allows taxpayers to request additional time to file their map 813d bcctp form.

Who is required to file map 813d bcctp extension?

Taxpayers who are unable to complete and submit their map 813d bcctp form by the original deadline are required to file the extension.

How to fill out map 813d bcctp extension?

To fill out the map 813d bcctp extension, taxpayers should include their name, taxpayer identification number, and a statement explaining the reason for the requested extension.

What is the purpose of map 813d bcctp extension?

The purpose of the map 813d bcctp extension is to provide taxpayers with additional time to gather the necessary information and complete their map 813d bcctp form.

What information must be reported on map 813d bcctp extension?

The map 813d bcctp extension form requires taxpayers to report their name, taxpayer identification number, and provide a statement explaining the reason for the requested extension.