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Form ODM01912 Certificate of Medical Necessity: Therapeutic Footwear for Individuals With Diabetes - Ohio
What Is Form ODM01912?
This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ODM01912?
A: Form ODM01912 is the Certificate of Medical Necessity for Therapeutic Footwear for Individuals With Diabetes in Ohio.
Q: Who needs to fill out Form ODM01912?
A: Form ODM01912 needs to be filled out by individuals with diabetes who require therapeutic footwear.
Q: Why is Form ODM01912 necessary?
A: Form ODM01912 is necessary to certify the medical necessity of therapeutic footwear for individuals with diabetes.
Q: Is there a fee for submitting Form ODM01912?
A: No, there is no fee for submitting Form ODM01912.
Q: What information is required on Form ODM01912?
A: Form ODM01912 requires information such as the patient's name, medical diagnosis, healthcare provider details, and details of the prescribed therapeutic footwear.
Q: How long does it take to process Form ODM01912?
A: The processing time for Form ODM01912 may vary, but it is typically within 30 days.
Q: Can I appeal if my Form ODM01912 is denied?
A: Yes, you can appeal if your Form ODM01912 is denied. The denial letter will provide instructions on how tofile an appeal.
Q: Who can I contact for more information about Form ODM01912?
A: For more information about Form ODM01912, you can contact the Ohio Department of Medicaid or your healthcare provider.
Form Details:
- Released on July 1, 2018;
- The latest edition provided by the Ohio Department of Medicaid;
- 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 ODM01912 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
