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Form DHS-5732-ENG Community Health Clinic Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-5732-ENG?
This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DHS-5732-ENG Community Health Clinic Provider Assurance Statement?
A: The DHS-5732-ENG Community Health Clinic Provider Assurance Statement is a form used by Community Health Clinics in Minnesota to validate their eligibility and participation in the Minnesota Health Care Programs (MHCP).
Q: Who needs to complete the DHS-5732-ENG Community Health Clinic Provider Assurance Statement?
A: Community Health Clinics in Minnesota who participate in the Minnesota Health Care Programs (MHCP) need to complete the DHS-5732-ENG form.
Q: What is the purpose of the DHS-5732-ENG Community Health Clinic Provider Assurance Statement?
A: The purpose of the DHS-5732-ENG form is to ensure that Community Health Clinics meet the required eligibility and participation criteria of the Minnesota Health Care Programs (MHCP).
Q: Is the completion of the DHS-5732-ENG Community Health Clinic Provider Assurance Statement mandatory?
A: Yes, completion of the DHS-5732-ENG form is mandatory for Community Health Clinics in Minnesota participating in the Minnesota Health Care Programs (MHCP).
Q: What happens if a Community Health Clinic does not complete the DHS-5732-ENG form?
A: If a Community Health Clinic fails to complete the DHS-5732-ENG form, they may lose their eligibility to participate in the Minnesota Health Care Programs (MHCP).
Q: Are there any fees involved in submitting the DHS-5732-ENG Community Health Clinic Provider Assurance Statement?
A: No, there are no fees associated with submitting the DHS-5732-ENG form.
Q: What other documents are required along with the DHS-5732-ENG Community Health Clinic Provider Assurance Statement?
A: Along with the DHS-5732-ENG form, Community Health Clinics may be required to submit additional documents such as proof of accreditation, licenses, and certificates.
Q: How often do Community Health Clinics need to submit the DHS-5732-ENG Community Health Clinic Provider Assurance Statement?
A: Community Health Clinics need to submit the DHS-5732-ENG form annually to maintain their participation in the Minnesota Health Care Programs (MHCP).
Form Details:
- Released on August 1, 2021;
- The latest edition provided by the Minnesota 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 DHS-5732-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
