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Form ODM01904 Request for Need Verification: Repair of Durable Medical Equipment (Other Than Wheelchairs), Prostheses, or Orthotic Devices - Ohio
What Is Form ODM01904?
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 ODM01904?
A: ODM01904 is a form for requesting need verification for the repair of durable medical equipment (other than wheelchairs), prostheses, or orthotic devices in the state of Ohio.
Q: What type of equipment does ODM01904 cover?
A: ODM01904 covers the repair of durable medical equipment (other than wheelchairs), prostheses, or orthotic devices.
Q: Who can use ODM01904?
A: ODM01904 can be used by individuals or providers who need to request need verification for the repair of durable medical equipment (other than wheelchairs), prostheses, or orthotic devices.
Q: What is the purpose of ODM01904?
A: The purpose of ODM01904 is to request need verification for the repair of durable medical equipment (other than wheelchairs), prostheses, or orthotic devices.
Q: When should I submit ODM01904?
A: ODM01904 should be submitted when you need to request need verification for the repair of durable medical equipment (other than wheelchairs), prostheses, or orthotic devices.
Q: Is there a fee for submitting ODM01904?
A: There is no fee for submitting ODM01904.
Q: Is ODM01904 specific to Ohio?
A: Yes, ODM01904 is specific to the state of Ohio.
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 ODM01904 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
