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DSS Form 37126 Out of State Provider Enrollment Form and Agreement - South Carolina
What Is DSS Form 37126?
This is a legal form that was released by the South Carolina Department of Social Services - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DSS Form 37126?
A: DSS Form 37126 is the Out of State Provider Enrollment Form and Agreement used in South Carolina.
Q: What is the purpose of the DSS Form 37126?
A: The DSS Form 37126 is used to enroll out-of-state providers in South Carolina's Medicaid program.
Q: Who needs to fill out the DSS Form 37126?
A: Out-of-state providers who want to participate in South Carolina's Medicaid program need to fill out the DSS Form 37126.
Form Details:
- Released on June 1, 2013;
- The latest edition provided by the South Carolina Department of Social Services;
- 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 DSS Form 37126 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Social Services.
Download DSS Form 37126 Out of State Provider Enrollment Form and Agreement - South Carolina
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