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Form FA-96 Nevada Medicaid Hospice Extended Care Physician Review Form - Nevada
What Is Form FA-96?
This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the purpose of Form FA-96?
A: Form FA-96 is used for Nevada Medicaid Hospice Extended CarePhysician Review.
Q: Who uses Form FA-96?
A: Form FA-96 is used by physicians conducting reviews for Nevada Medicaid Hospice Extended Care.
Q: What information is required on Form FA-96?
A: Form FA-96 requires the physician's name, date of review, and specific details regarding the patient's hospice extended care.
Q: Is Form FA-96 specific to Nevada?
A: Yes, Form FA-96 is specific to Nevada Medicaid Hospice Extended Care Physician Review.
Form Details:
- Released on February 23, 2017;
- The latest edition provided by the Nevada 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 fillable version of Form FA-96 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
