Get the free www.hhs.nd.govsiteswww1915(i) CARE COORDINATION REQUEST REPORT Immediately upon ...

1915(i) CARE COORDINATION REQUEST REPORT Rev (4/2022)Immediately upon completion, submit form via email to: nd1915i@nd.govThis form is utilized by the care coordination agency to inform ND Department

How to fill out wwwhhsndgovsiteswww1915i care coordination request

How to fill out wwwhhsndgovsiteswww1915i care coordination request

1. To fill out the www.hhs.gov/sites/www.1915i care coordination request, follow these steps:
2. Obtain the care coordination request form from the www.hhs.gov website.
3. Read through the instructions and requirements on the form to ensure you have all the necessary information.
4. Fill out your personal information, including your full name, address, and contact details.
5. Provide information about your current healthcare provider and any existing care coordination plans you may have.
6. Specify the type of care coordination services you require and the reasons for your request.
7. Attach any relevant supporting documents, such as medical records or referral letters.
8. Review the completed form to ensure all the information is accurate and complete.
9. Submit the care coordination request form through the designated submission method stated on the form.
10. Keep a copy of the submitted form for your records.
11. Wait for a response from the relevant authority regarding your care coordination request.

Who needs wwwhhsndgovsiteswww1915i care coordination request?

1. Anyone who requires specialized care coordination services, particularly those covered under the 1915(i) home and community-based services program, can submit a www.hhs.gov/sites/www.1915i care coordination request. This includes individuals with disabilities, elderly individuals, and individuals with chronic illnesses who need assistance in managing their healthcare services and accessing necessary support.

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What is wwwhhsndgovsiteswww1915i care coordination request?

wwwhhsndgovsiteswww1915i care coordination request is a request for coordination of care services for individuals under the 1915i Medicaid Waiver program.

Who is required to file wwwhhsndgovsiteswww1915i care coordination request?

Providers and care coordination agencies are required to file wwwhhsndgovsiteswww1915i care coordination request.

How to fill out wwwhhsndgovsiteswww1915i care coordination request?

wwwhhsndgovsiteswww1915i care coordination request can be filled out online through the designated portal or submitted via mail with the required documentation.

What is the purpose of wwwhhsndgovsiteswww1915i care coordination request?

The purpose of wwwhhsndgovsiteswww1915i care coordination request is to ensure proper coordination of care services for individuals enrolled in the 1915i Medicaid Waiver program.

What information must be reported on wwwhhsndgovsiteswww1915i care coordination request?

Information such as the individual's demographics, medical history, current care plan, and requested services must be reported on wwwhhsndgovsiteswww1915i care coordination request.