PDF
Word
Form ODM04066 Notice of Reduction, Suspension, or Termination of Medical Services by Your Managed Care Plan - Ohio
What Is Form ODM04066?
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 ODM04066?
A: ODM04066 is the Notice of Reduction, Suspension, or Termination of Medical Services by Your Managed Care Plan in Ohio.
Q: What does the notice ODM04066 inform about?
A: The notice ODM04066 informs about the reduction, suspension, or termination of medical services by your managed care plan.
Q: Who is this notice for?
A: This notice is for individuals who receive medical services through a managed care plan in Ohio.
Q: What does a reduction in medical services mean?
A: A reduction in medical services means that certain medical services will be decreased or limited.
Q: What does a suspension in medical services mean?
A: A suspension in medical services means that certain medical services will be temporarily halted or put on hold.
Q: What does a termination of medical services mean?
A: A termination of medical services means that certain medical services will be completely ended or discontinued.
Q: What should I do if I receive this notice?
A: If you receive this notice, you should carefully read and understand its contents, and reach out to your managed care plan for further information or to address any concerns.
Q: Can I appeal the reduction, suspension, or termination of medical services?
A: Yes, you have the right to appeal the reduction, suspension, or termination of medical services. The notice should provide information on how to initiate an appeal.
Q: What happens if my appeal is approved?
A: If your appeal is approved, the managed care plan will either reverse the reduction, suspension, or termination of medical services, or provide an alternative solution to meet your medical needs.
Q: What should I do if my appeal is denied?
A: If your appeal is denied, you may have further options to seek a resolution or review, such as filing a complaint with the appropriate regulatory agency or seeking legal advice.
Q: Is there a time limit for filing an appeal?
A: Yes, there is usually a time limit for filing an appeal. It is important to carefully review the notice and follow the instructions regarding the appeal timeline.
Form Details:
- Released on January 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 ODM04066 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
Download Form ODM04066 Notice of Reduction, Suspension, or Termination of Medical Services by Your Managed Care Plan - Ohio
1
2
