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Get Va Form 10 1245c

Rovals are obtained from both Departments' approving authorities. Agreements may go into effect more than 46 days after receipt if a later date is indicated in Box 3. 2. If additional resources are required to implement an agreement, approval must be obtained from the Department providing the resources prior to submitting the proposal. 3. The organization providing care should prepare a claim for services/care provided on an approved industry standard claim form (i.e. CMS 1500 / UB 04), if possi.

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