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Form HCA13-879 Agreement to Pay for Healthcare Services - Washington
What Is Form HCA13-879?
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 HCA13-879?
A: Form HCA13-879 is an Agreement to Pay for Healthcare Services in Washington.
Q: What is the purpose of Form HCA13-879?
A: The purpose of Form HCA13-879 is to establish an agreement between an individual and a healthcare provider to pay for healthcare services.
Q: Who needs to fill out Form HCA13-879?
A: Form HCA13-879 needs to be filled out by individuals who are seeking healthcare services in Washington and want to make an agreement to pay for those services.
Q: Are there any fees for filling out Form HCA13-879?
A: There may be fees associated with filling out Form HCA13-879, depending on the healthcare provider or facility.
Q: Can I refuse to fill out Form HCA13-879?
A: While you have the right to refuse to fill out Form HCA13-879, it may impact your ability to receive healthcare services from the provider or facility.
Q: What happens after I fill out Form HCA13-879?
A: After you fill out Form HCA13-879, the healthcare provider or facility will review the form and determine if they can provide healthcare services based on your agreement to pay.
Q: What if I cannot afford to pay for healthcare services?
A: If you cannot afford to pay for healthcare services, you may be eligible for financial assistance programs or other options. It is important to discuss your situation with the healthcare provider or facility.
Q: Is Form HCA13-879 specific to Washington?
A: Yes, Form HCA13-879 is specific to Washington and is used to establish an agreement to pay for healthcare services in the state.
Q: Is Form HCA13-879 required by law?
A: The requirement for Form HCA13-879 may vary depending on the healthcare provider or facility, but it is a common form used in Washington to establish an agreement to pay for healthcare services.
Form Details:
- Released on July 1, 2017;
- The latest edition provided by the Washington State Health Care Authority;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form HCA13-879 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
Download Form HCA13-879 Agreement to Pay for Healthcare Services - Washington
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