This is a legal form that was released by the Louisiana Department of Health - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is OCDD-PF-20-005?
A: OCDD-PF-20-005 is the form for Medicaid Freedom of Choice List for Waiver Services Provider Request in Louisiana.
Q: What is Medicaid Freedom of Choice List?
A: Medicaid Freedom of Choice List allows Medicaid recipients to select their preferred provider for waiver services.
Q: What is a waiver service provider?
A: A waiver service provider is a healthcare provider or organization that offers services covered under Medicaid waiver programs.
Q: How do I request to be added to the Medicaid Freedom of Choice List?
A: To be added to the Medicaid Freedom of Choice List, you need to complete and submit the OCDD-PF-20-005 form.
Q: Can I request multiple waiver service providers?
A: Yes, you can request multiple waiver service providers on the OCDD-PF-20-005 form.
Q: Is there a deadline for submitting the form?
A: The deadline for submitting the OCDD-PF-20-005 form may vary, so it is best to check with the Louisiana Medicaid office for the specific deadline.
Q: What happens after I submit the form?
A: After you submit the OCDD-PF-20-005 form, your request will be reviewed by the appropriate Medicaid office and you will be notified of the outcome.
Q: Can I change my chosen waiver service provider later?
A: Yes, you can change your chosen waiver service provider by submitting a new OCDD-PF-20-005 form.
Form Details:
Download a fillable version of Form OCDD-PF-20-005 by clicking the link below or browse more documents and templates provided by the Louisiana Department of Health.