PDF
Word
Form DHS-6189F-ENG Chore Services Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-6189F-ENG?
This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DHS-6189F-ENG form?A: The DHS-6189F-ENG form is the Chore Services ProviderAssurance Statement for Minnesota Health Care Programs (MHCP) in Minnesota.
Q: What is the purpose of the Chore Services Provider Assurance Statement?A: The Chore Services Provider Assurance Statement is used to ensure that providers of chore services for Minnesota Health Care Programs comply with program requirements.
Q: Who needs to fill out the DHS-6189F-ENG form?A: The providers of chore services for Minnesota Health Care Programs need to fill out the DHS-6189F-ENG form.
Q: Are there any fees associated with submitting the DHS-6189F-ENG form?A: No, there are no fees associated with submitting the DHS-6189F-ENG form.
Q: What happens after I submit the DHS-6189F-ENG form?A: After you submit the DHS-6189F-ENG form, it will be reviewed by the program administrator to determine if you meet the program requirements.
Q: What are the consequences of not filling out the DHS-6189F-ENG form?A: If you do not fill out the DHS-6189F-ENG form, you may not be eligible to provide chore services for Minnesota Health Care Programs.
Q: How often do I need to fill out the DHS-6189F-ENG form?A: You need to fill out the DHS-6189F-ENG form when you initially apply to become a provider of chore services and then renew it annually.
Q: What other documents do I need to submit along with the DHS-6189F-ENG form?A: Along with the DHS-6189F-ENG form, you may need to submit supporting documents such as proof of licensure or certification, proof of liability insurance, and background checks.
Form Details:
- Released on August 1, 2021;
- The latest edition provided by the Minnesota 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 DHS-6189F-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
