Medicaid Health Home Provider Selection / Change Form - South Dakota

Medicaid Health Home Provider Selection / Change Form - South Dakota

Medicaid Health Home Provider Selection/Change Form is a legal document that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota.

FAQ

Q: What is the Medicaid Health Home Provider Selection/Change Form?
A: The Medicaid Health Home Provider Selection/Change Form is a form used in South Dakota to select or change your Medicaid Health Home provider.

Q: Who can use the Medicaid Health Home Provider Selection/Change Form?
A: Any individual enrolled in South Dakota Medicaid can use the form to select or change their Health Home provider.

Q: What is a Medicaid Health Home provider?
A: A Medicaid Health Home provider is a healthcare organization or provider that coordinates and manages all aspects of an individual's healthcare.

Q: Why would someone want to change their Medicaid Health Home provider?
A: There could be various reasons why someone may want to change their Medicaid Health Home provider, such as wanting to switch to a provider closer to their home or finding a provider that better meets their healthcare needs.

Q: How do you fill out the Medicaid Health Home Provider Selection/Change Form?
A: The form requires you to provide your personal information, Medicaid ID, and the name and contact information of the provider you want to select or change to.

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Form Details:

  • The latest edition currently provided by the South Dakota Department of Social Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.

Download Medicaid Health Home Provider Selection / Change Form - South Dakota

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