PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form ODM01705
for the current year.
Form ODM01705 Notice of Continued Enrollment in the Coordinated Services Program (CSP) - Ohio
What Is Form ODM01705?
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 ODM01705?
A: ODM01705 is the Notice of Continued Enrollment in the Coordinated Services Program (CSP) in Ohio.
Q: What is the Coordinated Services Program (CSP)?
A: The Coordinated Services Program (CSP) is a program in Ohio that provides integrated care for individuals who are eligible for both Medicaid and Medicare.
Q: Who receives the ODM01705?
A: Individuals who are enrolled in the Coordinated Services Program (CSP) in Ohio receive the ODM01705.
Q: What is the purpose of the ODM01705?
A: The purpose of the ODM01705 is to notify individuals enrolled in the Coordinated Services Program (CSP) in Ohio that their enrollment will continue.
Q: Is the ODM01705 mandatory?
A: Yes, if you are enrolled in the Coordinated Services Program (CSP) in Ohio, you are required to receive and acknowledge the ODM01705.
Q: What should I do if I receive the ODM01705?
A: If you receive the ODM01705, you should review the information provided and follow any instructions or contact the appropriate agency if you have any questions or concerns.
Q: Can I opt-out of the Coordinated Services Program (CSP) in Ohio?
A: Yes, you have the right to request to opt-out of the Coordinated Services Program (CSP) in Ohio. You should contact the appropriate agency for more information on how to do so.
Form Details:
- Released on January 1, 2019;
- 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 ODM01705 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
