Edi Annual Certification of Electronically-Submitted Medicaid Claims - Dental Benefit Management Program - Louisiana

Edi Annual Certification of Electronically-Submitted Medicaid Claims - Dental Benefit Management Program is a legal document that was released by the Louisiana Department of Health - a government authority operating within Louisiana.

Form Details:

• The latest edition currently provided by the Louisiana Department of Health;
• Ready to use and print;
• Easy to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Louisiana Department of Health.