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Form NMO-4 Recipient Request Pharmacy Lock-In Change - Nevada
What Is Form NMO-4?
This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form NMO-4?
A: Form NMO-4 is a Recipient Request Pharmacy Lock-In Change form.
Q: What is the purpose of Form NMO-4?
A: The purpose of Form NMO-4 is to request a change in pharmacy lock-in for Nevada Medicaid recipients.
Q: Who should use Form NMO-4?
A: Form NMO-4 should be used by Nevada Medicaid recipients who want to request a change in their pharmacy lock-in.
Q: Is there a fee to submit Form NMO-4?
A: No, there is no fee to submit Form NMO-4.
Q: How long does it take to process Form NMO-4?
A: The processing time for Form NMO-4 can vary, but it typically takes a few weeks.
Q: What information do I need to provide on Form NMO-4?
A: You will need to provide your personal information, Medicaid ID number, and the reason for the pharmacy lock-in change.
Q: Can I make multiple requests for pharmacy lock-in changes?
A: Yes, you can make multiple requests for pharmacy lock-in changes, but they will be reviewed on a case-by-case basis.
Form Details:
- Released on February 1, 2019;
- The latest edition provided by the Nevada Department of Health and Human 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 fillable version of Form NMO-4 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
