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STATE OF MONTANA Department of Public Health and Human ServicesDPHHSOM300B (Rev. 02/2019)FAX completed form, within three (3) working days, to DP HHS TSD/NCB Network Security Unit at (406) 4445924 If
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dphhs-om-300b is a form used by the Department of Public Health and Human Services to collect data on certain healthcare programs.
Healthcare providers and facilities participating in the specified programs are required to file dphhs-om-300b.
To fill out dphhs-om-300b, providers need to provide detailed information about the services rendered and the number of patients served.
The purpose of dphhs-om-300b is to track and monitor the utilization of healthcare services and assess the effectiveness of the programs.
Information such as patient demographics, services provided, and outcomes must be reported on dphhs-om-300b.
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