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WPS GHA PART B REDETERMINATION REQUEST Formal fields are REQUIRED State service was performed in: MI Provider Information (requests with incomplete information will be dismissed) Provider Transaction

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What is state service was performed?

State service refers to any service provided by a government agency.

Who is required to file state service was performed?

Any individual or entity that has received state services may be required to file.

How to fill out state service was performed?

You can fill out the state service performed form online or submit a physical copy to the appropriate government agency.

What is the purpose of state service was performed?

The purpose is to track and report the usage of state services by individuals or entities.

What information must be reported on state service was performed?

You must report details of the specific state services received, the duration of the services, and any associated costs.

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