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Medicaid Credit Balance Report Form - South Dakota
Medicaid Credit Balance Report Form is a legal document that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota.
FAQ
Q: What is the Medicaid Credit Balance Report Form?
A: The Medicaid Credit Balance Report Form is a document used in South Dakota to report any overpaid credits to Medicaid providers.
Q: Who is required to complete the Medicaid Credit Balance Report Form?
A: Medicaid providers who have received overpaid credits are required to complete the form.
Q: How often should the Medicaid Credit Balance Report Form be submitted?
A: The form should be submitted annually, within 120 days of the provider's fiscal year-end.
Q: What information is required to complete the Medicaid Credit Balance Report Form?
A: The form requires information such as provider name, provider number, Medicare number, and detailed credits for each individual resident.
Form Details:
- Released on August 1, 2018;
- The latest edition currently provided by the South Dakota Department of Social Services;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.
Download Medicaid Credit Balance Report Form - South Dakota
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