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New Hampshire Petition for Special Medicaid Representative

New Hampshire Petition for Special Medicaid Representative

Name: New Hampshire Petition for Special Medicaid Representative
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.81 (491 reviews)

Category:

New Hampshire Statewide - Probate Court - General

State:

New Hampshire

Control #:

NH-SKU-0810

Format:

Instant download

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Description

Petition for Special Medicaid Representative The New Hampshire Petition for Special Medicaid Representative is a form that can be filed with the New Hampshire Department of Health and Human Services (HHS), Division of Family Assistance to appoint a representative to assist in the management of an applicant's Medicaid benefits. This form is used to appoint an individual or an organization to act as an applicant's representative on their behalf in matters related to their Medicaid coverage, including the filing of claims, application for services, and appeals of decisions made by HHS. There are three types of New Hampshire Petition for Special Medicaid Representative: Individual Representative, Organization Representative, and Designated Representative. An Individual Representative is an individual appointed by the applicant to act on their behalf. An Organization Representative is an organization appointed by the applicant to represent them in matters related to their Medicaid coverage. A Designated Representative is an individual or organization appointed by the applicant to manage their Medicaid benefits and act as their representative in all matters related to their Medicaid coverage.

The New Hampshire Petition for Special Medicaid Representative is a form that can be filed with the New Hampshire Department of Health and Human Services (HHS), Division of Family Assistance to appoint a representative to assist in the management of an applicant's Medicaid benefits. This form is used to appoint an individual or an organization to act as an applicant's representative on their behalf in matters related to their Medicaid coverage, including the filing of claims, application for services, and appeals of decisions made by HHS. There are three types of New Hampshire Petition for Special Medicaid Representative: Individual Representative, Organization Representative, and Designated Representative. An Individual Representative is an individual appointed by the applicant to act on their behalf. An Organization Representative is an organization appointed by the applicant to represent them in matters related to their Medicaid coverage. A Designated Representative is an individual or organization appointed by the applicant to manage their Medicaid benefits and act as their representative in all matters related to their Medicaid coverage.

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FAQ

NH Medicaid (Medical Assistance) is a federal and state funded health care program that serves a wide range of individuals and families who meet certain eligibility requirements.

90 calendar days from the application date for Aid to the Permanently and Totally Disabled (APTD), Nursing Facility (NF) services, all Home and Community-Based Care (HCBC) services, including Choices for Independence (CFI) services, Medicaid for Employed Adults with Disabilities (MEAD), and Medicaid for Employed Older

Contact the DHHS Customer Service Center toll-free at 1-844-ASK-DHHS (1-844-275-3447) (TDD Relay Access: 1-800-735-2964), Monday through Friday, a.m. to p.m. ET. Contact your local District Office. Visit Related Resources for additional eligibility information.

Service authorization requests for Medicaid Fee for Service recipients can be found on the MMIS online portal. All service authorizations should be submitted via secure email at ServiceAuthorizationFFS@dhhs.nh.gov.

Henry Lipman, Director As Medicaid Director, Henry Lipman is the New Hampshire state lead for coordination with the U.S. Centers for Medicaid and Medicare Services.

To participate in NH Medicaid (Medical Assistance), federal law requires the Department to cover certain groups of individuals.

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If you are a Medicaid member in need of a Medicaid form, handbook or other materials, you've come to the right place. Authorized Representative FormThe Petitioner alleges the following facts which demonstrate the need for the appointment of a. Special Medicaid Representative pursuant to RSA 151-I:2: 11. If someone is helping you fill out this application, you may need to complete Appendix C. Apply faster online. Apply faster online at HealthCare.gov. Section 1: Appointment of Representative. Clinics, group practices, and other suppliers must complete this application to enroll in the Medicare program and receive a Medicare billing number. Appointment of a "special Medicaid representative" to complete and to prosecute a Medicaid application to successful conclusion. The program will include a.

New Hampshire Petition for Special Medicaid Representative

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