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Form DHCS4516 Ccs Dental and Orthodontic Client Service Authorization Request (Sar) - California
What Is Form DHCS4516?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DHCS4516 CCS Dental and Orthodontic Client Service Authorization Request?
A: DHCS4516 CCS Dental and Orthodontic Client Service Authorization Request is a form used in California to request authorization for dental and orthodontic services for clients under the California Children's Services (CCS) program.
Q: What is the purpose of the DHCS4516 form?
A: The DHCS4516 form is used to request authorization for dental and orthodontic services for clients who are eligible for the California Children's Services (CCS) program.
Q: Who can use the DHCS4516 form?
A: The DHCS4516 form can be used by dental and orthodontic providers to request authorization for services for clients who are eligible for the California Children's Services (CCS) program.
Q: Is there a fee for submitting the DHCS4516 form?
A: No, there is no fee for submitting the DHCS4516 form.
Form Details:
- Released on September 1, 2015;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS4516 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form DHCS4516 Ccs Dental and Orthodontic Client Service Authorization Request (Sar) - California
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