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Form DDD-2099A Electronic Visit Verification (Evv) Member Contingency / Back-Up Plan - Arizona
What Is Form DDD-2099A?
This is a legal form that was released by the Arizona Department of Economic Security - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DDD-2099A?A: Form DDD-2099A is a document related to Electronic Visit Verification (EVV) Member Contingency/Back-Up Plan.
Q: What is Electronic Visit Verification (EVV)?A: Electronic Visit Verification (EVV) is a system that electronically verifies the delivery of services by home care providers.
Q: What is the purpose of Form DDD-2099A?A: The purpose of Form DDD-2099A is to outline a contingency/back-up plan for members receiving services through EVV.
Q: Who uses Form DDD-2099A?A: Form DDD-2099A is used by members receiving services through EVV in Arizona.
Q: What does the form include?A: The form includes information about the member's preferred method of contact, backup caregiver information, and emergency contact details.
Q: Why is a contingency/back-up plan important for EVV?A: A contingency/back-up plan ensures that services can still be provided in case of any issues with the primary caregiver or the EVV system.
Form Details:
- Released on September 1, 2021;
- The latest edition provided by the Arizona Department of Economic Security;
- 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 DDD-2099A by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.
Download Form DDD-2099A Electronic Visit Verification (Evv) Member Contingency / Back-Up Plan - Arizona
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