Form DHS-6189CC-ENG Personal Emergency Response System Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

Form DHS-6189CC-ENG Personal Emergency Response System Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

What Is Form DHS-6189CC-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-6189CC-ENG form?
A: The DHS-6189CC-ENG form is the Personal Emergency Response System Provider Assurance Statement form.

Q: What does the form apply to?
A: The form applies to the Minnesota Health Care Programs (Mhcp) in Minnesota.

Q: What is a Personal Emergency Response System (PERS)?
A: A Personal Emergency Response System (PERS) is a device or service that helps individuals call for help in the event of an emergency.

Q: What is the purpose of the Provider Assurance Statement?
A: The purpose of the Provider Assurance Statement is to ensure that PERS providers comply with certain requirements set by the Minnesota Health Care Programs.

Q: Who needs to complete this form?
A: PERS providers participating in the Minnesota Health Care Programs need to complete this form.

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

Download Form DHS-6189CC-ENG Personal Emergency Response System Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

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