PDF
Word
Form DHS-3932-ENG Limited General Dentist Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-3932-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-3932-ENG Limited General Dentist Assurance Statement?
A: The DHS-3932-ENG Limited General Dentist Assurance Statement is a document pertaining to Minnesota Health Care Programs (MHCP) in Minnesota.
Q: What is Minnesota Health Care Programs (MHCP)?
A: Minnesota Health Care Programs (MHCP) is a program that provides healthcare coverage to eligible individuals in Minnesota.
Q: Who is the document intended for?
A: The document is intended for limited general dentists participating in Minnesota Health Care Programs (MHCP).
Q: What is the purpose of this document?
A: The purpose of this document is to obtain an assurance statement from limited general dentists participating in Minnesota Health Care Programs (MHCP).
Q: What is an assurance statement?
A: An assurance statement is a written declaration by a limited general dentist regarding their compliance with certain requirements of Minnesota Health Care Programs (MHCP).
Q: What are the requirements mentioned in this document?
A: The specific requirements mentioned in this document pertain to the provision of dental services to MHCP enrollees and compliance with billing and documentation guidelines.
Q: Are all general dentists required to complete this assurance statement?
A: No, only limited general dentists participating in Minnesota Health Care Programs (MHCP) are required to complete this assurance statement.
Q: Is there a deadline for submitting this document?
A: Yes, limited general dentists must submit this assurance statement within a specified timeframe, as indicated by Minnesota Health Care Programs (MHCP).
Q: What happens if a limited general dentist fails to submit this assurance statement?
A: Failure to submit the assurance statement may result in consequences such as suspension or termination from participation in 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-3932-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
