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OCT Official Form No.: 960AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT TO HIPAA This form has been approved by the New York State Department of Health Patient Name Date of Biosocial Security
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How to fill out estate recovery - department

01
To fill out estate recovery - department, follow these steps:
02
Gather all the necessary documents, such as the death certificate, proof of assets, and any other relevant paperwork.
03
Identify the specific department or agency responsible for estate recovery in your jurisdiction. This information can usually be found on the official government website or by contacting the appropriate government office.
04
Complete the required forms or applications for estate recovery. These forms may ask for information about the deceased person's assets, debts, and any relevant insurance policies.
05
Ensure that you provide accurate and complete information on the forms. Double-check all the details before submitting them.
06
Submit the completed forms and any supporting documents to the designated department or agency. Follow the instructions provided by the department for submission.
07
Keep copies of all the forms and documents for your records.
08
Wait for a response from the department. They may require additional information or documentation, so be prepared to provide any requested materials.
09
Cooperate with the department throughout the estate recovery process. Be responsive to their inquiries and provide any requested information in a timely manner.
10
If approved, follow any instructions provided by the department for transferring assets or fulfilling any obligations related to estate recovery.
11
Consult with an attorney or legal professional if you have any questions or concerns about the estate recovery process.

Who needs estate recovery - department?

01
Estate recovery - department is needed by individuals or families who have received government assistance or benefits, particularly in the form of Medicaid or long-term care support.
02
When a person who received such assistance passes away, the government or relevant department has the right to recover or reclaim funds or assets from the person's estate to reimburse for the assistance provided.
03
Therefore, anyone who has received government assistance and anticipates having an estate to pass on to their heirs or beneficiaries should be aware of the estate recovery process and may need to engage with the estate recovery department.
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Estate recovery refers to the process by which state Medicaid programs seek reimbursement for benefits paid on behalf of a deceased individual from their estate.
The estate of the deceased individual who received Medicaid benefits is required to file estate recovery claims.
To fill out the estate recovery form, you typically need to provide information about the deceased's assets, liabilities, and any Medicaid benefits received, following the specific guidelines set by the department.
The purpose of estate recovery is to ensure that states can recoup Medicaid costs from the estates of deceased beneficiaries, aiding in sustaining the Medicaid program.
The information that must be reported includes the deceased individual's name, Social Security number, date of death, details of Medicaid services received, and asset information.
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