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Form DMA-5124 Medicaid Transportation Provider Documentation - North Carolina
What Is Form DMA-5124?
This is a legal form that was released by the North Carolina Department of Health and Human Services - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DMA-5124?
A: DMA-5124 is a Medicaid Transportation Provider Documentation form used in North Carolina.
Q: Who uses DMA-5124?
A: Medicaid transportation providers in North Carolina use DMA-5124.
Q: What is the purpose of DMA-5124?
A: The purpose of DMA-5124 is to document transportation services provided to Medicaid beneficiaries.
Q: Do I need to fill out DMA-5124?
A: If you are a Medicaid transportation provider in North Carolina, you may need to fill out DMA-5124 for documentation purposes.
Q: Are there any instructions for completing DMA-5124?
A: Yes, the DMA-5124 form comes with instructions on how to fill it out properly.
Q: What kind of information do I need to provide on DMA-5124?
A: On DMA-5124 form, you need to provide information about the transportation services provided, Medicaid beneficiary details, and other relevant information.
Q: Can I submit DMA-5124 electronically?
A: Yes, you can submit DMA-5124 electronically through the NCTracks Provider Portal.
Form Details:
- Released on June 6, 2012;
- The latest edition provided by the North Carolina Department of Health and 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 printable version of Form DMA-5124 by clicking the link below or browse more documents and templates provided by the North Carolina Department of Health and Human Services.
Download Form DMA-5124 Medicaid Transportation Provider Documentation - North Carolina
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