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Form DMS-845 Pooling Request Form - Arkansas Medicaid Patient-Centered Medical Home Program - Arkansas
What Is Form DMS-845?
This is a legal form that was released by the Arkansas Department of Human Services - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form DMS-845?
A: Form DMS-845 is the Pooling Request Form for the Arkansas Medicaid Patient-Centered Medical Home (PCMH) Program.
Q: What is the Arkansas Medicaid Patient-Centered Medical Home Program?
A: The Arkansas Medicaid Patient-Centered Medical Home Program is a program that promotes coordinated and comprehensive care for Medicaid patients.
Q: What is the purpose of the Pooling Request Form?
A: The purpose of the Pooling Request Form is to request reimbursement for services provided by the PCMH.
Q: Who can use the Form DMS-845?
A: Healthcare providers participating in the Arkansas Medicaid PCMH Program can use the Form DMS-845.
Form Details:
- Released on August 1, 2022;
- The latest edition provided by the Arkansas Department of Human 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 fillable version of Form DMS-845 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Human Services.
Download Form DMS-845 Pooling Request Form - Arkansas Medicaid Patient-Centered Medical Home Program - Arkansas
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