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Form DOH-4486 Change in Payor Filing Status - New York
What Is Form DOH-4486?
This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DOH-4486?
A: Form DOH-4486 is the Change in Payor Filing Status form for New York.
Q: What is the purpose of Form DOH-4486?
A: The purpose of this form is to notify the New York Department of Health about a change in payor filing status.
Q: Who needs to fill out Form DOH-4486?
A: Any individual or organization that has experienced a change in payor filing status in New York needs to fill out this form.
Q: What information is required on Form DOH-4486?
A: The form requires information such as the previous payor, effective date of the change, and new payor details.
Q: Is there a deadline for submitting Form DOH-4486?
A: Yes, the form should be submitted to the New York Department of Health within 30 days of the payor filing status change.
Q: Are there any fees associated with submitting Form DOH-4486?
A: There are no fees associated with submitting this form.
Q: What should I do if I have questions or need assistance with Form DOH-4486?
A: If you have any questions or need assistance, you can contact the New York Department of Health for guidance.
Form Details:
- Released on May 1, 2012;
- The latest edition provided by the New York State Department of Health;
- 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 DOH-4486 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.
