Form DOH-4459 End of Month Covered Lives Enrollment Option for Payors - New York

Form DOH-4459 End of Month Covered Lives Enrollment Option for Payors - New York

What Is Form DOH-4459?

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-4459?
A: Form DOH-4459 is the End of Month Covered Lives Enrollment Option for Payors in New York.

Q: Who is required to fill out Form DOH-4459?
A: Payors in New York are required to fill out Form DOH-4459.

Q: What does Form DOH-4459 capture?
A: Form DOH-4459 captures the end of month covered lives enrollment information for payors.

Q: When is Form DOH-4459 due?
A: Form DOH-4459 is typically due by the 15th day of the month following the end of the reporting period.

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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-4459 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.

Download Form DOH-4459 End of Month Covered Lives Enrollment Option for Payors - New York

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