Form LCR-1084A Application for Renewal or Amended Hcbs Certificate for Independent Providers - Arizona

What Is Form LCR-1084A?

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 LCR-1084A?A: LCR-1084A is the form used to apply for renewal or amendment of the Home and Community Based Services (HCBS) Certificate for Independent Providers in Arizona.

Q: Who can use the LCR-1084A form?A: The LCR-1084A form can be used by independent providers in Arizona who need to renew or amend their HCBS Certificate.

Q: What is the purpose of the HCBS Certificate for Independent Providers?A: The HCBS Certificate is issued by the Arizona Department of Economic Security (DES) and allows independent providers to deliver services to individuals with disabilities in their own homes or community settings.

Q: When should I use the LCR-1084A form?A: You should use the LCR-1084A form when your HCBS Certificate is up for renewal or when you need to make amendments to your existing certificate.

Q: What information do I need to provide on the LCR-1084A form?A: The LCR-1084A form requires you to provide your personal information, details about your provider agency (if applicable), and information about the services you provide.

Q: Are there any fees associated with the LCR-1084A form?A: Yes, there may be fees associated with the renewal or amendment of your HCBS Certificate. The fees can vary, so it's best to check with the Arizona Department of Economic Security (DES) for the current fee schedule.

Q: What is the deadline for submitting the LCR-1084A form?A: The deadline for submitting the LCR-1084A form depends on when your HCBS Certificate expires. It's important to submit your application before the expiry date to avoid any disruption in services.

Q: How long does it take to process the LCR-1084A form?A: The processing time for the LCR-1084A form can vary. It's best to check with the Arizona Department of Economic Security (DES) for the current processing times.

Q: What should I do if my LCR-1084A form is denied?A: If your LCR-1084A form is denied, you will receive notification from the Arizona Department of Economic Security (DES) with information on how to appeal the decision.