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Form DSS-MS-101 Advance Recipient Notice of Non-coverage - South Dakota
What Is Form DSS-MS-101?
This is a legal form that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DSS-MS-101?A: Form DSS-MS-101 is the Advance Recipient Notice of Non-coverage.
Q: What does this form pertain to?A: This form pertains to non-coverage of certain healthcare services in South Dakota.
Q: Why would I receive this form?A: You would receive this form if a healthcare service you are requesting is not covered by your insurance or Medicaid in South Dakota.
Q: What should I do if I receive this form?A: If you receive this form, you should review it carefully and consider alternative options for obtaining the necessary healthcare services.
Q: Can I appeal the non-coverage decision?A: Yes, you have the right to appeal the non-coverage decision. The form provides information on how to initiate an appeal.
Q: Is this form specific to South Dakota?A: Yes, this form is specific to South Dakota and its Medicaid program.
Form Details:
- Released on November 1, 2022;
- The latest edition provided by the South Dakota Department of Social 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 DSS-MS-101 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.
