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Form DHCS4491 Health Assessment Provider Program Agreement - California
What Is Form DHCS4491?
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 the DHCS4491 Health Assessment Provider Program Agreement?A: The DHCS4491 Health Assessment Provider Program Agreement is a contract between the California Department of Health Care Services (DHCS) and a health assessment provider.
Q: What is the purpose of the DHCS4491 Health Assessment Provider Program Agreement?A: The purpose of the agreement is to establish the terms and conditions for a health assessment provider to participate in the DHCS Health Assessment Provider Program.
Q: Who is involved in the DHCS4491 Health Assessment Provider Program Agreement?A: The California Department of Health Care Services (DHCS) and a health assessment provider are the parties involved in the agreement.
Q: What does the DHCS Health Assessment Provider Program involve?A: The DHCS Health Assessment Provider Program aims to improve health outcomes by providing health assessments to eligible individuals.
Q: Who can participate in the DHCS Health Assessment Provider Program?A: Eligible providers, such as clinics, hospitals, and community health centers, can participate in the program.
Q: What are the terms and conditions specified in the DHCS4491 Health Assessment Provider Program Agreement?A: The agreement outlines requirements for training, documentation, reporting, quality assurance, and reimbursement for services provided by the health assessment provider.
Form Details:
- Released on January 1, 2008;
- The latest edition provided by the California Department of Health Care 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 DHCS4491 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the California Department of Health Care Services.
