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Form DHS-7120B-ENG Early Intensive Developmental and Behavioral Intervention (Eidbi) Provider Agency Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-7120B-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 purpose of Form DHS-7120B-ENG?
A: The purpose of Form DHS-7120B-ENG is to provide assurance from an Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Agency to the Minnesota Health Care Programs (MHCP) in Minnesota.
Q: What does EIDBI stand for?
A: EIDBI stands for Early Intensive Developmental and Behavioral Intervention.
Q: Who is required to submit Form DHS-7120B-ENG?
A: EIDBI Provider Agencies in Minnesota are required to submit Form DHS-7120B-ENG to MHCP.
Q: What is the Minnesota Health Care Programs (MHCP)?
A: MHCP is a program in Minnesota that provides health care coverage for eligible individuals.
Q: What is the purpose of the Provider Agency Assurance Statement?
A: The Provider Agency Assurance Statement is a document that ensures the EIDBI Provider Agency will comply with the requirements set forth by MHCP.
Form Details:
- Released on February 1, 2023;
- 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-7120B-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
Download Form DHS-7120B-ENG Early Intensive Developmental and Behavioral Intervention (Eidbi) Provider Agency Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
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