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Get Dma 51118b

Transportation assistance is provided to a Medicaid recipient, for audit purposes, it is necessary to document that the individual received a Medicaid covered service from a Medicaidenrolled provider on the date of transport. Please complete the following: This is to certify that visited this office or facility on (Medicaid recipient s name/Medicaid ID Number) and received a Medicaid covered service. (date) Name of Medicaid provider/.

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Keywords relevant to Dma 51118b

  • HANDOUT
  • verification
  • audit
  • enrolled
  • recipient
  • provider
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