Form DHS-6189I-ENG Family Training and Counseling Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota

What Is Form DHS-6189I-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-6189I-ENG form?A: The DHS-6189I-ENG form is the Family Training and Counseling Provider Assurance Statement.

Q: What is the purpose of the Assurance Statement?A: The Assurance Statement is used for Family Training and Counseling providers in Minnesota Health Care Programs (MHCP).

Q: Who is required to submit the Assurance Statement?A: Family Training and Counseling providers participating in Minnesota Health Care Programs (MHCP) are required to submit the Assurance Statement.

Q: What is the Minnesota Health Care Programs (MHCP)?A: Minnesota Health Care Programs (MHCP) is a program that provides health care coverage to eligible residents of Minnesota.

Q: What information is required on the Assurance Statement?A: The Assurance Statement requires the provider's name, address, National Provider Identifier (NPI), provider type, signature, and date.

Q: Is the Assurance Statement submission mandatory?A: Yes, Family Training and Counseling providers participating in Minnesota Health Care Programs (MHCP) are required to submit the Assurance Statement.

Q: What happens if a Family Training and Counseling provider does not submit the Assurance Statement?A: Failure to submit the Assurance Statement may result in a provider's disenrollment from Minnesota Health Care Programs (MHCP).

Q: Are there any fees associated with submitting the Assurance Statement?A: No, there are no fees associated with submitting the Assurance Statement.