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 Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 05-255 KO?
A: DSHS Form 05-255 KO is a form related to Medicaid Transformation Demonstration in Washington.
Q: What is the purpose of the form?
A: The purpose of the form is to provide notice of action and exceptions to the rule in the Medicaid Transformation Demonstration.
Q: Who is the form for?
A: The form is for individuals and families participating in the Medicaid Transformation Demonstration in Washington.
Q: What is Medicaid Transformation Demonstration?
A: Medicaid Transformation Demonstration is a program in Washington aimed at improving the delivery of healthcare services for Medicaid recipients.
Form Details:
Download a printable version of DSHS Form 05-255 KO by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.