Form DHS-3535A-ENG Organization - Mhcp Provider Profile Change Form - Minnesota

What Is Form DHS-3535A-ENG?

This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DHS-3535A-ENG?
A: DHS-3535A-ENG is the form number for the MHCP Provider Profile Change Form in Minnesota.

Q: What is the purpose of the DHS-3535A-ENG form?
A: The purpose of the DHS-3535A-ENG form is to request changes to the Minnesota Health Care Programs (MHCP) provider profile.

Q: Who needs to fill out the DHS-3535A-ENG form?
A: Providers participating in the MHCP need to fill out the DHS-3535A-ENG form.

Q: How can I submit the DHS-3535A-ENG form?
A: You can submit the completed DHS-3535A-ENG form by mail or fax to the MHCP provider enrollment unit.

Q: Are there any fees associated with the DHS-3535A-ENG form?
A: No, there are no fees associated with submitting the DHS-3535A-ENG form.

Q: What types of changes can be requested using the DHS-3535A-ENG form?
A: The DHS-3535A-ENG form can be used to request changes such as adding or terminating services, changing provider contact information, or updating billing or payment preferences.

Q: What supporting documentation is required with the DHS-3535A-ENG form?
A: The required supporting documentation may vary depending on the type of change being requested. It is recommended to review the form instructions for specific documentation requirements.

Q: How long does it take to process the DHS-3535A-ENG form?
A: The processing time for the DHS-3535A-ENG form can vary. It is recommended to submit the form well in advance of the desired effective date of the requested changes.