Form DMS-845 Pooling Request Form - Arkansas Medicaid Patient-Centered Medical Home Program - Arkansas

Form DMS-845 Pooling Request Form - Arkansas Medicaid Patient-Centered Medical Home Program - Arkansas

What Is Form DMS-845?

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

FAQ

Q: What is the Form DMS-845?A: Form DMS-845 is the Pooling Request Form for the Arkansas Medicaid Patient-Centered Medical Home (PCMH) Program.

Q: What is the Arkansas Medicaid Patient-Centered Medical Home Program?A: The Arkansas Medicaid Patient-Centered Medical Home Program is a program that promotes coordinated and comprehensive care for Medicaid patients.

Q: What is the purpose of the Pooling Request Form?A: The purpose of the Pooling Request Form is to request reimbursement for services provided by the PCMH.

Q: Who can use the Form DMS-845?A: Healthcare providers participating in the Arkansas Medicaid PCMH Program can use the Form DMS-845.

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Form Details:

  • Released on August 1, 2022;
  • The latest edition provided by the Arkansas Department of Human Services;
  • 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 DMS-845 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Human Services.

Download Form DMS-845 Pooling Request Form - Arkansas Medicaid Patient-Centered Medical Home Program - Arkansas

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