This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Vietnamese. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the DSHS Form 15-492?
A: The DSHS Form 15-492 is a Medicaid Transformation Demonstration Service Notice.
Q: What does the Medicaid Transformation Demonstration Service Notice do?
A: The Medicaid Transformation Demonstration Service Notice provides information related to Medicaid transformation in Washington.
Q: Who is it for?
A: It is for Vietnamese-speaking individuals in Washington who receive Medicaid benefits.
Q: What information does it contain?
A: The notice contains information about changes to Medicaid services and how they may affect individuals.
Form Details:
Download a printable version of DSHS Form 15-492 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.