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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DSS-NEMT-971
for the current year.
Form DSS-NEMT-971 Non-emergency Medical Travel (Nemt) Reimbursement Form - Overnight Trip - South Dakota
What Is Form DSS-NEMT-971?
This is a legal form that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DSS-NEMT-971 form?
A: The DSS-NEMT-971 form is the Non-emergency Medical Travel (NEMT) Reimbursement form for overnight trips in South Dakota.
Q: Who can use the DSS-NEMT-971 form?
A: The DSS-NEMT-971 form can be used by individuals who require non-emergency medical travel and are eligible for reimbursement in South Dakota.
Q: What is the purpose of the DSS-NEMT-971 form?
A: The purpose of the DSS-NEMT-971 form is to claim reimbursement for eligible medical travel expenses incurred during overnight trips.
Q: What information is required on the DSS-NEMT-971 form?
A: The DSS-NEMT-971 form requires information such as the traveler's name, Medicaid number, trip details, and supporting documentation of expenses.
Form Details:
- Released on December 1, 2021;
- The latest edition provided by the South Dakota Department of Social Services;
- 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 DSS-NEMT-971 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.
Download Form DSS-NEMT-971 Non-emergency Medical Travel (Nemt) Reimbursement Form - Overnight Trip - South Dakota
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