Get the free ACT/CTT Medicaid Lapse Notification Form - Providers - PerformCare. ACT/CTT Medicaid...
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ACT/CTT Medicaid Lapse Notification Form(Providers should submit this form to PerformCare when a Members Medicaid eligibility has ended and funding transfer occurred)Members Name: ___MAID#: ___Members
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What is actctt medicaid lapse notification?
The ACTC TT Medicaid Lapse Notification is a formal notice issued to inform relevant parties about the discontinuation of Medicaid coverage due to various reasons such as failure to meet eligibility criteria or non-renewal of the Medicaid application.
Who is required to file actctt medicaid lapse notification?
Individuals and entities that administer Medicaid services, such as healthcare providers and case managers, are required to file the ACTC TT Medicaid Lapse Notification when a Medicaid beneficiary experiences a lapse in their coverage.
How to fill out actctt medicaid lapse notification?
To fill out the ACTC TT Medicaid Lapse Notification, one must provide accurate and complete information regarding the beneficiary's details, the reason for the lapse, dates of coverage, and any relevant documentation supporting the lapse.
What is the purpose of actctt medicaid lapse notification?
The purpose of the ACTC TT Medicaid Lapse Notification is to formally document and notify the appropriate authorities about an individual's lapse in Medicaid coverage, ensuring compliance with regulatory requirements and facilitating timely resolution.
What information must be reported on actctt medicaid lapse notification?
The ACTC TT Medicaid Lapse Notification must report the beneficiary's name, Medicaid number, reason for lapse, effective dates of the lapse, and any other pertinent details related to the coverage interruption.
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