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ACTION: RevisedDATE: 05/19/2014 2:47 Rule Summary and Fiscal Analysis (Part A) Ohio Department of Medicaid Agency NameTommi Potter DivisionContact50 Town St 4th floor Columbus OH 4321827096147523877Agency

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What is 5160-27-05 amendment?

The 5160-27-05 amendment is a regulatory form used to amend specific information related to Medicaid services in Ohio.

Who is required to file 5160-27-05 amendment?

Providers of Medicaid services in Ohio who need to update or correct information regarding their services or payment must file the 5160-27-05 amendment.

How to fill out 5160-27-05 amendment?

To fill out the 5160-27-05 amendment, providers should complete all necessary sections as indicated in the form's instructions, providing accurate and updated information regarding their services.

What is the purpose of 5160-27-05 amendment?

The purpose of the 5160-27-05 amendment is to allow Medicaid providers to make necessary updates or corrections to their information to ensure compliance and accurate billing.

What information must be reported on 5160-27-05 amendment?

The 5160-27-05 amendment must report updated provider information, service details, and any changes affecting Medicaid billing and reimbursement.

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