Form ODM01718 Notice of Denial of Assigned Provider or Pharmacy in the Coordinated Services Program (CSP) - Ohio

What Is Form ODM01718?

This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on December 1, 2021;
• The latest edition provided by the Ohio Department of Medicaid;
• 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 ODM01718 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Ohio Department of Medicaid.