NC DHB-5202-C 2013 free printable template
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APPENDIX C Designation of Authorized Representative You can give a trusted person permission to talk about this application with us, see your information, and act for your on matters related to this
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How to fill out NC DHB-5202-C
01
Obtain the NC DHB-5202-C form from the official website or designated office.
02
Begin filling out the form by entering your personal information, including name, address, and contact information.
03
Provide details about the service or information you are requesting, ensuring to be as specific as possible.
04
Include any additional information or documentation required to support your request.
05
Review the form for accuracy and completeness before submitting.
06
Submit the completed form through the specified submission method, such as online, by mail, or in-person.
Who needs NC DHB-5202-C?
01
Individuals or organizations seeking specific services or information from the North Carolina Department of Health and Human Services.
02
Service providers needing to request approval or communicate with the NC DHHS.
03
Anyone who is required to document certain health-related information or requests as part of state regulations.
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People Also Ask about
What is the Medicaid Integrity Program NC?
The Deficit Reduction Act of 2005 created the Medicaid Integrity Program. The Act directed the Centers for Medicare and Medicaid Services to provide effective support and assistance to states to combat Medicaid provider fraud and abuse.
What are the different types of Medicaid in NC?
NC Medicaid Managed Care Health Plans. Behavioral Health I/DD Tailored Plans. EBCI Tribal Option. Health Plan Contracts.
How do I appeal my Medicaid claim in NC?
Please contact the Smart NC program at 855-408-1212 or you can complete and submit a Request for Assistance form along with the items on the Medical Appeal Checklist. We look forward to assisting you with your health insurance issues and concerns.
What is the income limit for Medicaid in NC 2023?
The Medically Needy Income Limit (MNIL) has remained the same for many years, and in 2023, continues to be $242 / month for a single individual and $317 / month for a married couple.
What is NC Medicaid changing to in 2023?
This means effective April 1, 2023, state Medicaid programs are no longer required to maintain continuous coverage for beneficiaries. North Carolina began the renewal (recertification) process for Medicaid beneficiaries April 1, 2023.
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What is NC DHB-5202-C?
NC DHB-5202-C is a form used in North Carolina for reporting specific data related to healthcare services and facilities.
Who is required to file NC DHB-5202-C?
Healthcare providers and facilities in North Carolina that meet certain criteria are required to file NC DHB-5202-C.
How to fill out NC DHB-5202-C?
To fill out NC DHB-5202-C, complete all required sections accurately, providing detailed information as requested, and submit it according to the stated guidelines.
What is the purpose of NC DHB-5202-C?
The purpose of NC DHB-5202-C is to collect and analyze healthcare data to ensure compliance, improve healthcare services, and conduct research.
What information must be reported on NC DHB-5202-C?
NC DHB-5202-C must report information such as facility identifiers, service types, patient statistics, and any other relevant healthcare metrics.
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