This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 13-712 for the current year.
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 13-712?
A: DSHS Form 13-712 is a form used to request Behavioral Health Personal Care services in Washington for BHO/MCO funding.
Q: What is BHO?
A: BHO stands for Behavioral Health Organization, which is responsible for coordinating behavioral health services in Washington.
Q: What is MCO?
A: MCO stands for Managed Care Organization, which is responsible for managing and organizing healthcare services in Washington.
Q: What is Behavioral Health Personal Care?
A: Behavioral Health Personal Care refers to services that support individuals with behavioral health needs in their daily activities, such as bathing, dressing, and medication management.
Q: Who can use DSHS Form 13-712?
A: Individuals in Washington who need Behavioral Health Personal Care services and are eligible for BHO/MCO funding can use this form.
Q: How do I fill out DSHS Form 13-712?
A: You need to provide your personal information, health condition details, and the requested Behavioral Health Personal Care services on the form.
Q: Is there a deadline to submit DSHS Form 13-712?
A: There may be specific deadlines for submitting the form, so it's best to check with your BHO/MCO or the DSHS for the most up-to-date information.
Q: Can I appeal if my request for BHO/MCO funding is denied?
A: Yes, you have the right to appeal if your request for BHO/MCO funding is denied. You can contact your BHO/MCO or the DSHS for information on the appeal process.
Form Details:
Download a printable version of DSHS Form 13-712 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.