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Instructions for DSHS Form 15-492 Medicaid Transformation Demonstration Service Notice - Washington
This document contains official instructions for DSHS Form 15-492 , Medicaid Transformation Demonstration Service Notice - a form released and collected by the Washington State Department of Social and Health Services.
FAQ
Q: What is DSHS Form 15-492?
A: DSHS Form 15-492 is a Medicaid Transformation Demonstration Service Notice in Washington.
Q: What is the purpose of the DSHS Form 15-492?
A: The purpose of the DSHS Form 15-492 is to provide information about the Medicaid Transformation Demonstration services in Washington.
Q: Who is required to fill out DSHS Form 15-492?
A: Individuals who are receiving or applying for Medicaid Transformation Demonstration services in Washington may be required to fill out DSHS Form 15-492.
Q: What information do I need to provide on DSHS Form 15-492?
A: You may need to provide personal identification information, Medicaid eligibility details, and other required information as specified on the form.
Instruction Details:
- This 1-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Washington State Department of Social and Health Services.
