PDF
Word
Form DHS-6189CC-ENG Personal Emergency Response System Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-6189CC-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-6189CC-ENG form?A: The DHS-6189CC-ENG form is the Personal Emergency Response System Provider Assurance Statement form.
Q: What does the form apply to?A: The form applies to the Minnesota Health Care Programs (Mhcp) in Minnesota.
Q: What is a Personal Emergency Response System (PERS)?A: A Personal Emergency Response System (PERS) is a device or service that helps individuals call for help in the event of an emergency.
Q: What is the purpose of the Provider Assurance Statement?A: The purpose of the Provider Assurance Statement is to ensure that PERS providers comply with certain requirements set by the Minnesota Health Care Programs.
Q: Who needs to complete this form?A: PERS providers participating in the Minnesota Health Care Programs need to complete this form.
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-6189CC-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
