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Face sheet: 1. Request Information (1 of 2)
A. The State of Washington requests a waiver/amendment under the authority of section 1915(b) of the Act. The Medicaid
agency will directly operate the
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What is facesheet 1 request information?
Facesheet 1 request information includes basic information about a person or entity who is requesting a service or filing a claim.
Who is required to file facesheet 1 request information?
Any individual or entity requesting a service or filing a claim is required to file facesheet 1 request information.
How to fill out facesheet 1 request information?
Facesheet 1 request information can be filled out by providing accurate and complete details about the requester or claimant using the designated form provided by the relevant authority.
What is the purpose of facesheet 1 request information?
The purpose of facesheet 1 request information is to collect essential details about the requester or claimant for processing services or claims effectively.
What information must be reported on facesheet 1 request information?
Facesheet 1 request information typically requires details such as name, contact information, service or claim details, and any other relevant information specified by the authority.
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