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DC DCF Third Party EVE Addendum v1.6 ___ Addendum to Third Party Alternate EVE System Specification v7.7 San data Technologies, LLC 26 Harbor Park Dr. Port Washington, NY 11050 Toll Free: 8005447263

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How to fill out dc dhcf third party

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Gather all necessary information such as name, address, and contact information of the third party.

02

Complete the appropriate sections of the DC DHCF Third Party Liability Form.

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Provide any supporting documentation or medical records as required.

04

Submit the completed form and any accompanying documentation to the relevant DC DHCF office.

Who needs dc dhcf third party?

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Individuals who have received healthcare services covered by DC Medicaid and may have additional insurance or coverage from a third party.

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What is dc dhcf third party?

The dc dhcf third party is a form used by third parties to report healthcare payments made on behalf of DC Medicaid recipients.

Who is required to file dc dhcf third party?

Any third party that makes healthcare payments on behalf of DC Medicaid recipients is required to file dc dhcf third party.

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The dc dhcf third party form can be filled out electronically or manually with all relevant payment information disclosed.

What is the purpose of dc dhcf third party?

The purpose of dc dhcf third party is to track and monitor payments made by third parties on behalf of DC Medicaid recipients for proper reimbursement and oversight.

What information must be reported on dc dhcf third party?

The dc dhcf third party form requires information such as the recipient's name, Medicaid ID, date of service, service provider, payment amount, and any other relevant details.

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