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Form DHS-4223-ENG Assignment of Payment for Day Training and Habilitation Services - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-4223-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 Form DHS-4223-ENG?
A: Form DHS-4223-ENG is the Assignment of Payment for Day Training and Habilitation Services form for Minnesota Health Care Programs (MHCP).
Q: What is Day Training and Habilitation Services?
A: Day Training and Habilitation Services are programs that provide support and training to individuals with disabilities to help them develop skills and participate in community activities.
Q: What are Minnesota Health Care Programs (MHCP)?
A: Minnesota Health Care Programs (MHCP) refer to a range of state-sponsored healthcare programs in Minnesota, including medical assistance, MinnesotaCare, and other public health insurance programs.
Q: Why is the Assignment of Payment form necessary?
A: The Assignment of Payment form is necessary to authorize the direct payment of Day Training and Habilitation Services to the provider on behalf of the individual receiving the services.
Q: Who should use Form DHS-4223-ENG?
A: Form DHS-4223-ENG should be used by individuals or their legal representatives who receive Day Training and Habilitation Services through Minnesota Health Care Programs (MHCP).
Q: Is the Assignment of Payment form mandatory?
A: Yes, the Assignment of Payment form is mandatory for individuals receiving Day Training and Habilitation Services through Minnesota Health Care Programs (MHCP).
Q: Are there any fees associated with Form DHS-4223-ENG?
A: No, there are no fees associated with completing and submitting Form DHS-4223-ENG.
Q: What information is needed to complete Form DHS-4223-ENG?
A: To complete Form DHS-4223-ENG, you will need to provide information such as the individual's name, MHCP ID, provider information, and a signature authorizing the assignment of payment.
Form Details:
- Released on January 1, 2022;
- 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-4223-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
