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WORK RULES POLICY NUMBER:10002 REPLACES POLICY DATED: 4/5/2004EFFECTIVE DATE:APPOINTING AUTHORITY APPROVAL:1/6/2008 AUTHORITY:POLICY The Department of Administrative Services (WAS) Work Rules provide

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How to fill out ati - dhcs

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To fill out the ATI-DHCS form, follow these steps:

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Begin by entering the necessary personal information, such as name, date of birth, address, etc.

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Provide details about your health insurance coverage, including the policy number and any other relevant information.

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Specify the reason for filling out the form, such as applying for Medi-Cal or seeking eligibility determination.

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ATI-DHCS is needed by individuals who are applying for or seeking eligibility determination for Medi-Cal.

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What is ati - dhcs?

Ati - dhcs stands for Annual Tax Information - Department of Health Care Services. It is a form used to report tax information related to healthcare services.

Who is required to file ati - dhcs?

Healthcare providers and organizations who received payments from the Department of Health Care Services are required to file ati - dhcs.

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The purpose of ati - dhcs is to report tax information related to healthcare services provided and payments received from the Department of Health Care Services.

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Information such as total payments received, deductions, and any other relevant tax information related to healthcare services must be reported on ati - dhcs.

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