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Form SFN606 Medicaid out of State Services Certification - North Dakota
What Is Form SFN606?
This is a legal form that was released by the North Dakota Department of Health and Human Services - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form SFN606?
A: Form SFN606 is the Medicaid Out of State Services Certification form used in North Dakota.
Q: What is Medicaid in North Dakota?
A: Medicaid is a government health insurance program for low-income individuals and families in North Dakota.
Q: What are Out of State Services?
A: Out of State Services refer to medical services received by Medicaid recipients outside of North Dakota.
Q: Why is Form SFN606 needed?
A: Form SFN606 is needed to certify that the requested out of state services are necessary and cannot be provided within North Dakota.
Q: Who needs to complete Form SFN606?
A: Form SFN606 needs to be completed by the Medicaid recipient's physician or healthcare provider.
Q: Are there any fees associated with out of state services?
A: Fees for out of state services may vary depending on the specific circumstances and Medicaid program rules.
Q: How long does it take to process Form SFN606?
A: The processing time for Form SFN606 may vary, but it is recommended to submit the form as soon as possible before the out of state services are needed.
Q: Can I appeal if Form SFN606 is denied?
A: Yes, if Form SFN606 is denied, you have the right to appeal the decision and request a fair hearing.
Q: Who can I contact for more information?
A: For more information, you can contact the North Dakota Department of Human Services or your local Medicaid office.
Form Details:
- Released on February 1, 2012;
- The latest edition provided by the North Dakota 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 SFN606 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Health and Human Services.
