PDF
Word
Form DHCS9052 Genetically Handicapped Persons Program (Ghpp) New Referral Form - California
What Is Form DHCS9052?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DHCS9052?A: DHCS9052 is the Genetically Handicapped Persons Program (GHPP) New Referral Form in California.
Q: What is the Genetically Handicapped Persons Program (GHPP)?A: The GHPP is a program in California that provides specialized medical services for individuals with certain genetically handicapping conditions.
Q: What is the purpose of the DHCS9052 form?A: The DHCS9052 form is used to refer individuals to the GHPP for specialized medical services.
Q: Who can use the DHCS9052 form?A: Healthcare providers and facilities can use the DHCS9052 form to refer individuals to the GHPP.
Q: What information is required on the DHCS9052 form?A: The DHCS9052 form requires basic personal information, genetic diagnosis, medical history, and supporting documentation.
Q: Are there any eligibility requirements for the GHPP?A: Yes, individuals must meet certain income and residency requirements to be eligible for the GHPP.
Q: How long does it take to process the DHCS9052 form?A: The processing time may vary, but it typically takes several weeks to process the DHCS9052 form and determine eligibility for the GHPP.
Q: Can individuals already enrolled in Medi-Cal use the DHCS9052 form?A: No, individuals who are already enrolled in Medi-Cal should not use the DHCS9052 form to refer to the GHPP. They should contact their Medi-Cal provider for appropriate referrals.
Q: Is there a cost to participate in the GHPP?A: No, there is no cost to participate in the GHPP as it is funded by the state of California.
Form Details:
- Released on August 1, 2007;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS9052 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
