|
DHB-1061 Checklist for Child Medical Evaluation (CME) Reporting
|
Sep 18, 2023 03:25 PM
|
|
DHB-2039 PHP Notification of Nursing Facility Level of Care
|
Dec 07, 2022 09:55 AM
|
|
DHB-2040 Tribal and Indian Health Services
|
Jan 07, 2021 12:00 AM
|
|
DHB-2040B Tribal and Indian Health Services
|
Sep 23, 2021 11:40 AM
|
|
DHB-2043 Third Party Recovery Accident Information Form
|
Sep 17, 2019 03:40 PM
|
|
DHB-2044ia Medicaid Credit Balance Report
|
Jul 07, 2023 07:56 AM
|
|
DHB-2045 Instructions for Completing Medicaid Credit Balance Report
|
Jul 07, 2023 07:45 AM
|
|
DHB-2050 Voluntary Request to Terminate Medicaid
|
Apr 03, 2023 08:05 AM
|
|
DHB-2055 Reimbursement for Medical Transportation
|
May 17, 2022 04:25 PM
|
|
DHB-2056 Purchased Medical Transportation Costs
|
May 09, 2022 09:05 AM
|
|
DHB-2190 Internal Inspection Report
|
Aug 15, 2023 01:45 PM
|
|
DHB-2191 Designation of Control Officer for FRR/Beer Reports
|
Aug 15, 2023 01:48 PM
|
|
DHB-2192 SSA Training Form - County Staff and County Contract Staff
|
Aug 15, 2023 01:49 PM
|
|
DHB-2193 Memorandum of CAP Waiver Enrollment
|
Oct 21, 2020 10:25 AM
|
|
DHB-2194 IRC Rules Handout
|
Aug 15, 2023 01:50 PM
|
|
DHB-2195 Documentation of Annual Security Training Confidentiality Form – County Staff
|
Aug 15, 2023 01:52 PM
|
|
DHB-2196 Documentation of Annual Security Training - Shred Contractor Training
|
Aug 15, 2023 01:53 PM
|
|
DHB-2197 FTI Record Keeping Log
|
Aug 15, 2023 01:54 PM
|
|
DHB-2198 Log for Destruction of the FRR/BEER Reports
|
Aug 15, 2023 02:00 PM
|
|
DHB-2199 Documentation of the Visitation Logs
|
Aug 15, 2023 02:02 PM
|
|
DHB-2200 Access Control Log
|
Aug 15, 2023 02:04 PM
|
|
DHB-2201 Confidentiality of Safeguard Data
|
Aug 15, 2023 02:05 PM
|
|
DHB-2202 Beneficiary Notice
|
Aug 15, 2023 02:06 PM
|
|
DHB-3051-ia Form and Instructions - Request for Independent Assessment for Personal Care Services - Attestation of Medical Need
|
Jul 09, 2021 03:40 PM
|
|
DHB-4037 Disability Determination Transmittal
|
Aug 08, 2017 03:20 PM
|
|
DHB-5001N Notice on the Use of Social Security Numbers
|
Jun 09, 2009 03:20 PM
|
|
DHB-5001N_sp AVISO SOBRE EL USO DE LOS NÚMEROS DE SEGURO SOCIAL
|
Feb 04, 2022 09:50 AM
|
|
DHB-5002 Important Notice About Your Medicaid or Special Assistance Approval
|
Sep 27, 2021 01:30 PM
|
|
DHB-5002sp-ia Lea Este Importante Aviso Sobre Medicail o la Asistencia Especial Aviso de Aprobacion
|
Jun 01, 2021 10:20 AM
|
|
DHB-5003 Medicaid Approval Notice
|
Jun 19, 2023 08:40 AM
|
