Get the free HEALTH HOME PROVIDER SELECTION FORM - benefits.sd.gov - benefits sd
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WAS INTERNAL USE RCD Date WAS Processor ID DAX Updated Provider Notice issued Scan as DT 535 HEALTH HOME PROVIDER SELECTION FORM BROOKINGS AREA Member Name: Member Date of Birth: Member ID Number
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What is health home provider selection?
Health home provider selection is the process of choosing a healthcare provider to coordinate care for an individual receiving Medicaid services.
Who is required to file health home provider selection?
Individuals receiving Medicaid services are required to file health home provider selection.
How to fill out health home provider selection?
Health home provider selection can be filled out online through the Medicaid website or by contacting the Medicaid office.
What is the purpose of health home provider selection?
The purpose of health home provider selection is to ensure coordinated and comprehensive care for individuals receiving Medicaid services.
What information must be reported on health home provider selection?
Information such as the chosen healthcare provider's name, contact information, and services offered must be reported on health home provider selection.
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