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Form 165B Hospice Recipient Status Change - Alabama
What Is Form 165B?
This is a legal form that was released by the Alabama Medicaid Agency - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 165B?A: Form 165B is a hospice recipient status change form.
Q: What is the purpose of Form 165B?A: The purpose of Form 165B is to report changes in the hospice recipient's status.
Q: Who should use Form 165B?A: Form 165B should be used by hospices in Alabama.
Q: What information is required on Form 165B?A: Form 165B requires information about the hospice recipient's name, Medicaid ID, and details of the status change.
Q: Are there any fees associated with Form 165B?A: No, there are no fees associated with Form 165B.
Form Details:
- Released on October 1, 2021;
- The latest edition provided by the Alabama Medicaid Agency;
- 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 165B by clicking the link below or browse more documents and templates provided by the Alabama Medicaid Agency.
