PDF
Word
Form DHS-114A Deductible Report - Michigan
What Is Form DHS-114A?
This is a legal form that was released by the Michigan Department of Health and Human Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DHS-114A?
A: Form DHS-114A is the Deductible Report for Michigan.
Q: Who is required to submit Form DHS-114A?
A: Agencies that provide Medicaid-funded services in Michigan are required to submit Form DHS-114A.
Q: What information does Form DHS-114A require?
A: Form DHS-114A requires agencies to report the total deductible amount for Medicaid recipients in Michigan.
Q: When is the deadline to submit Form DHS-114A?
A: The deadline to submit Form DHS-114A is typically by the 30th day of the month following the end of each quarter.
Form Details:
- Released on December 1, 2007;
- The latest edition provided by the Michigan Department of Health and Human 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 printable version of Form DHS-114A by clicking the link below or browse more documents and templates provided by the Michigan Department of Health and Human Services.
Download Form DHS-114A Deductible Report - Michigan
1
2
