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This version of the form is not currently in use and is provided for reference only. Download this version of
Form ODM01717
for the current year.
Form ODM01717 Notice of Proposed Enrollment in the Coordinated Services Program (CSP) - Ohio
What Is Form ODM01717?
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.
FAQ
Q: What is Form ODM01717?A: Form ODM01717 is the Notice of Proposed Enrollment in the Coordinated Services Program (CSP) in Ohio.
Q: What is the Coordinated Services Program (CSP)?A: The Coordinated Services Program (CSP) is a program in Ohio that provides coordinated care and services to individuals with complex health needs.
Q: Who is eligible for the Coordinated Services Program (CSP)?A: Individuals who are eligible for Medicaid and have complex health needs may be eligible for the Coordinated Services Program (CSP).
Q: What is the purpose of Form ODM01717?A: The purpose of Form ODM01717 is to notify individuals of their proposed enrollment in the Coordinated Services Program (CSP) in Ohio.
Q: What information is included in Form ODM01717?A: Form ODM01717 includes information such as the individual's name, Medicaid number, proposed CSP enrollment date, and contact information for questions or concerns.
Q: Is enrollment in the Coordinated Services Program (CSP) mandatory?A: Enrollment in the Coordinated Services Program (CSP) is not mandatory. It is optional for eligible individuals.
Q: What should I do if I have questions or concerns about my proposed enrollment in the Coordinated Services Program (CSP)?A: If you have questions or concerns about your proposed enrollment in the Coordinated Services Program (CSP), you can contact the phone number or email provided on Form ODM01717.
Form Details:
- Released on January 1, 2019;
- 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 ODM01717 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
