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Children's Mental Health Bureau NonMedicaid Services including Room and Board Application and AttestationDate of application: Name of Youth: Date of Birth: Social Security #: Is the youth living with

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What is non-medicaid services including room?

Non-medicaid services including room are services provided to individuals that are not covered by Medicaid, such as accommodations in a healthcare facility.

Who is required to file non-medicaid services including room?

Healthcare facilities and service providers are required to file non-medicaid services including room.

How to fill out non-medicaid services including room?

To fill out non-medicaid services including room, providers need to report all services provided, the cost of the services, and any accommodations provided.

What is the purpose of non-medicaid services including room?

The purpose of non-medicaid services including room is to track and report on services provided to individuals that are not covered by Medicaid.

What information must be reported on non-medicaid services including room?

Providers must report on all services provided, the cost of the services, any accommodations provided, and any other relevant information.