Get Dms 600 Form

Filling out the Dms 600 Form online is a straightforward process that ensures compliance with the necessary documentation required by the Arkansas Department of Human Services. This guide will provide you with step-by-step instructions to assist you in completing the form efficiently and accurately.

Follow the steps to fill out the Dms 600 Form online.

1. Click the ‘Get Form’ button to access the Dms 600 Form and open it in your preferred online editor.
2. Begin by entering the patient's full name in the designated field to accurately identify the individual for whom the form is being completed.
3. Next, provide the patient's Medicaid ID number in the appropriate section to ensure accurate processing of their application.
4. Fill in the date of the last physical examination, which must reflect the most recent visit regarding the patient's health.
5. Indicate the medical diagnosis that justifies the necessity of therapy services by entering it in the medical diagnosis field.
6. If applicable, enter the developmental diagnosis, ensuring it aligns with the medical diagnosis if they are the same.
7. Detail the clinical indications for treatment based on the evaluations conducted, providing supporting information for the necessity of therapy.
8. In the prescription block, specify the total number of therapy minutes required per week and the duration (in months) for which therapy is prescribed.
9. Enter any additional pertinent information that may be valuable for understanding the patient’s medical condition and planned treatment.
10. Include the name of the primary care physician and their Medicaid provider number in the relevant fields for verification.
11. If the child is exempt from primary care physician requirements, document the name and Medicaid provider number of the attending physician instead.
12. Finally, ensure the prescribing physician signs and dates the completed form with their original signature before submission.
13. After reviewing the filled sections, save your changes, then download, print, or share the Dms 600 Form as needed.

Complete your Dms 600 Form online today for efficient processing!