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Form HCA13-787 Out-of-State Medical Services Request - Washington
What Is Form HCA13-787?
This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form HCA13-787?
A: Form HCA13-787 is a request form for out-of-state medical services in Washington.
Q: When is Form HCA13-787 used?
A: Form HCA13-787 is used when a resident of Washington needs medical services outside of the state.
Q: How do I obtain Form HCA13-787?
A: Form HCA13-787 can be obtained from the Washington State Health Care Authority.
Q: What information is required on Form HCA13-787?
A: Form HCA13-787 requires information such as the patient's name, date of birth, medical provider's name, and reason for out-of-state services.
Q: Are there any fees associated with submitting Form HCA13-787?
A: There may be fees associated with submitting Form HCA13-787, depending on the specific circumstances.
Form Details:
- Released on December 1, 2012;
- The latest edition provided by the Washington State Health Care Authority;
- 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 printable version of Form HCA13-787 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
Download Form HCA13-787 Out-of-State Medical Services Request - Washington
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