Vermont Medicaid Child / Adolescent Inpatient Admission Notification Form - Vermont

Vermont Medicaid Child / Adolescent Inpatient Admission Notification Form - Vermont

Vermont Medicaid Child/Adolescent Inpatient Admission Notification Form is a legal document that was released by the Department of Vermont Health Access - a government authority operating within Vermont.

FAQ

Q: What is the Vermont Medicaid Child/Adolescent Inpatient Admission Notification Form?
A: The Vermont Medicaid Child/Adolescent Inpatient Admission Notification Form is a document used to notify Vermont Medicaid of a child or adolescent's inpatient admission.

Q: Who needs to complete the Vermont Medicaid Child/Adolescent Inpatient Admission Notification Form?
A: The form needs to be completed by the facility admitting a child or adolescent for inpatient treatment and submitted to Vermont Medicaid.

Q: What information is required on the form?
A: The form requires information about the patient, including their Medicaid number, demographics, and details of the inpatient admission.

Q: Why is the Vermont Medicaid Child/Adolescent Inpatient Admission Notification Form necessary?
A: The form is necessary to ensure that Medicaid is aware of the child or adolescent's inpatient admission and can coordinate and authorize the necessary coverage and services.

Q: Are there any deadlines for submitting the form?
A: While there are no specific deadlines mentioned, it is recommended to submit the form as soon as possible after the child or adolescent's inpatient admission.

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Form Details:

  • Released on January 31, 2020;
  • The latest edition currently provided by the Department of Vermont Health Access;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Department of Vermont Health Access.

Download Vermont Medicaid Child / Adolescent Inpatient Admission Notification Form - Vermont

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