Departments and Agencies

Forms

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Adjudication by Administrative Law Judge

Adjudication Order from Clarion Psychiatric Center Appeal

Administrative Order Regarding Appeal of Moses Taylor Hospital

Referral to Social Security Administration

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UPMC McKeesport Hospital Appeal Decision

Policy Clarifications - Medicaid - Long Term Care

Adjudication Order from the Pennsylvania Department of Public Welfare

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Operations Memorandum 10-02-03

UPMC Braddock Appeal Adjudication Document

UPMC Presbyterian Hospital Appeal Order

Kirkbride Center Appeal Adjudication

Adjudication Order for Appeal Case

Adjudication Decision of Appeal

Adjudication on Appeal of Perseus House, Inc.

Adjudication Order for Heron Home Health Care Appeal

DATA ENTRY FORM - services dpw state pa

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Adjudication Appeal from Department of Public Welfare

Adjudication Order for Appeal of The Children's Seashore House

Adjudication Order and Recommendation for Appeal

Pennsylvania utilization review fillable form

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Adjudication Order and Recommendation

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Adjudication Order for Appeal of UPMC Western Psychiatric Institute and Clinic

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Adjudication of Appeal

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Order and Adjudication of Appeal - CHS Berwick Hospital Center

Adjudication Order and Recommendation

Adjudication of Appeal - Greene County Memorial Hospital

Adjudication and Appeal Decision

Adjudication Order for Appeal of University of Pennsylvania Health System

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UPMC Presbyterian Hospital Appeal Adjudication

Adjudication Order

Policy Clarifications - Other

Operations Memorandum - Food Stamp

ORDER AND RECOMMENDATION FOR APPEAL OF ALTOONA HOSPITAL

COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE PROVIDER NAME/ADDRESS: Crozer Chester Medical Center 1 Medical Center Boulevard Upland, PA 19013-3995 PROVIDER'S REPRESENTATIVE Heather Kalup PROVIDER'S WITNESS (ES) XXXXXXXXXX - - -

Adjudication Order and Appeal Recommendation

Appeal of Grandview Health Homes

Appeal of Visiting Nurse Association

Policy Clarifications

Adjudication Document for UPMC Horizon Hospital Appeal

Adjudication Order for Medical Necessity Appeal

Adjudication Order - John XXIII Home v. OMAP

Appeal Adjudication for Ephrata Medical Equipment

Adjudication Order from the Department of Public Welfare

BAYADA NURSES APPEAL ADJUDICATION

Adjudication of Appeal for Patient Inpatient Admission Denial

Adjudication Order and Recommendation

Operations Memorandum - Medicaid

Adjudication of Appeal for Medical Assistance Services

Adjudication Appeal Decision

Administrative Appeal Decision

Adjudication and Recommendation of Appeal

Operations Memorandum - Medicaid OPS101101

LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM APPLICATION

Adjudication Order for Ambler Rest Center, Inc.

COMMONWEALTH OF PENNSYVLANIA DEPARTMENT OF PUBLIC WELFARE PROVIDER NAME/ADDRESS: UPMC MCKEESPORT ONE CRAWFORD BUILDING 1500 FIFTH AVENUE MCKEESPORT, PA 15132 PROVIDER'S REPRESENTATIVE RONALD OTT, PRESIDENT/CEO PROVIDER'S WITNESS (ES) - - -

DCED/DPW CRISIS INTERFACE REFERRAL FORM

Adjudication Order

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Siemon's Lakeview Manor Estate Appeal Order

Policy Clarifications Cash Assistance - All - PCA13039104

APPEAL OF COMFORT CARE HEALTH SERVICES

Adjudication Order and Recommendation

Appeal of Roxborough Memorial Hospital

Adjudication of Appeal for Clarion Psychiatric Center

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Adjudication and Order of Appeal

Adverse Action Appeal Decision

Adjudication Order of Appeal

Appeal of Temple University Health System

Policy Clarifications

Adjudication and Order Appeal

Agreement of Mutual Responsibility

ORDER AND RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE

Administrative Appeal - Appeal of Mary McIntosh

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