PDF
Word
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.
DSHS Form 13-712 Behavioral Health Personal Care (Bhpc) Request for Mco Funding - Washington
What Is DSHS Form 13-712?
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.
FAQ
Q: What is DSHS Form 13-712?
A: DSHS Form 13-712 is a Behavioral HealthPersonal Care (BHPC) Request for MCO Funding.
Q: What is BHPC?
A: BHPC stands for Behavioral Health Personal Care, which is a program that provides assistance and support to individuals with mental health or substance abuse disorders.
Q: What is MCO funding?
A: MCO funding refers to funding provided by Managed Care Organizations, which are health insurance plans that coordinate and manage medical services for Medicaid recipients.
Q: Who can use DSHS Form 13-712?
A: This form is used by individuals or their authorized representatives to request BHPC services and funding from MCOs in the state of Washington.
Form Details:
- Released on October 1, 2020;
- The latest edition provided by the Washington State Department of Social and Health 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 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.
Download DSHS Form 13-712 Behavioral Health Personal Care (Bhpc) Request for Mco Funding - Washington
1
2
3
