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NORTH CAROLINA COUNTY DEPARTMENT OF SOCIAL SERVICES REQUEST FOR FINANCIAL INFORMATION DATE TO: NAME: District # County Case # Program(s): (Last, First Middle) Address: SSN: SSN: SSN: We are in the.

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How to fill out the DSS 3431 online

The DSS 3431 form is an essential document used by the North Carolina County Department of Social Services to assess eligibility for public assistance. This guide provides clear, step-by-step instructions for completing this form online, ensuring a smooth process for all users.

Follow the steps to complete the DSS 3431 form online

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling out the personal information section. Enter the full name of the individual requesting assistance, along with the date, district number, county case number, and the relevant programs.
  3. Provide the current address and Social Security Number of the individual in the designated fields.
  4. In the customer consent section, ensure the individual signs and dates the authorization for access to financial records accurately.
  5. Complete the financial information section by indicating the status of various accounts such as checking, savings, and any other financial assets. Include current balances and whether accounts are jointly owned.
  6. If there are additional accounts or loans, attach a detailed list of these financial assets with type, account number, current balance, and interest earned.
  7. After all sections are completed, review the form for accuracy. Once satisfied, options will be available to save changes, download, print, or share the form.

Complete your DSS 3431 form online today to ensure your eligibility assessment progresses smoothly.

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Contact support

Contact NC Medicaid Contact Center. Phone: 888-245-0179. Provider Ombudsman. For provider inquiries, concerns, complaints regarding health plans. Medicaid.ProviderOmbudsman@dhhs.nc.gov. Phone: 866-304-7062. NCTracks Call Center. Phone: 800-688-6696.

The Medically Needy Income Limit (MNIL) has remained the same for many years, and in 2023, continues to be $242 / month for a single individual and $317 / month for a married couple.

If you have questions about this change, call the ACCU-CHEK Customer Care at 1-877-906-8969. You may also go to the ACCU- CHEK web site at .accu-chek.com. When changes occur, you must report them to your county case worker. You can report changes in person, by phone, or by mail to your case worker.

You can renew your NC Medicaid eligibility in three ways: Fill out the paperwork you received in the mail. Go online. In person at your county Department of Social Services (DSS) office.

Customer Service Agents are available to answer questions at this toll-free number: Phone: 800-688-6696. Calls are recorded to improve customer satisfaction. The Automated Voice Response System is encouraged to obtain claims status using a touch-tone phone.

Verify eligibility, health plan and primary care provider enrollment using the NCTracks Recipient Eligibility Verification/Response or calling the NCTracks Call Center for more information: 800-688-6696.

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