Form DHS-6189F-ENG Chore Services Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

Form DHS-6189F-ENG Chore Services Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

What Is Form DHS-6189F-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-6189F-ENG form?
A: The DHS-6189F-ENG form is the Chore Services ProviderAssurance Statement for Minnesota Health Care Programs (MHCP) in Minnesota.

Q: What is the purpose of the Chore Services Provider Assurance Statement?
A: The Chore Services Provider Assurance Statement is used to ensure that providers of chore services for Minnesota Health Care Programs comply with program requirements.

Q: Who needs to fill out the DHS-6189F-ENG form?
A: The providers of chore services for Minnesota Health Care Programs need to fill out the DHS-6189F-ENG form.

Q: Are there any fees associated with submitting the DHS-6189F-ENG form?
A: No, there are no fees associated with submitting the DHS-6189F-ENG form.

Q: What happens after I submit the DHS-6189F-ENG form?
A: After you submit the DHS-6189F-ENG form, it will be reviewed by the program administrator to determine if you meet the program requirements.

Q: What are the consequences of not filling out the DHS-6189F-ENG form?
A: If you do not fill out the DHS-6189F-ENG form, you may not be eligible to provide chore services for Minnesota Health Care Programs.

Q: How often do I need to fill out the DHS-6189F-ENG form?
A: You need to fill out the DHS-6189F-ENG form when you initially apply to become a provider of chore services and then renew it annually.

Q: What other documents do I need to submit along with the DHS-6189F-ENG form?
A: Along with the DHS-6189F-ENG form, you may need to submit supporting documents such as proof of licensure or certification, proof of liability insurance, and background checks.

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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-6189F-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.

Download Form DHS-6189F-ENG Chore Services Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

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