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ACTION: To Be RefiledDATE: 05/30/2017 3:36 Rule Summary and Fiscal Analysis (Part A) Ohio Department of Medicaid Agency Name Daniel M Arnold DivisionContact50 W Town Street, Ste 400 Columbus OH 4321500006147523525Agency
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5160-27-04 new is a specific form used in the regulatory process for health care providers to report certain information to the state.
Health care providers and organizations that participate in state Medicaid programs are required to file 5160-27-04 new.
To fill out 5160-27-04 new, providers must gather the relevant data, complete each section of the form accurately, and ensure that all required documentation is attached before submission.
The purpose of 5160-27-04 new is to collect vital data on services rendered by health care providers for reimbursement and compliance purposes within state Medicaid programs.
The information that must be reported on 5160-27-04 new includes provider details, services provided, patient demographics, and financial information related to claims.
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