Form DHS-114A Deductible Report - Michigan

Form DHS-114A Deductible Report - Michigan

What Is Form DHS-114A?

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

FAQ

Q: What is Form DHS-114A?
A: Form DHS-114A is the Deductible Report for Michigan.

Q: Who is required to submit Form DHS-114A?
A: Agencies that provide Medicaid-funded services in Michigan are required to submit Form DHS-114A.

Q: What information does Form DHS-114A require?
A: Form DHS-114A requires agencies to report the total deductible amount for Medicaid recipients in Michigan.

Q: When is the deadline to submit Form DHS-114A?
A: The deadline to submit Form DHS-114A is typically by the 30th day of the month following the end of each quarter.

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Form Details:

  • Released on December 1, 2007;
  • The latest edition provided by the Michigan Department of Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form DHS-114A by clicking the link below or browse more documents and templates provided by the Michigan Department of Health and Human Services.

Download Form DHS-114A Deductible Report - Michigan

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