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Form DFA-NEMT-1a Supplement to Application for Nemt Reimbursement Program - West Virginia
What Is Form DFA-NEMT-1a?
This is a legal form that was released by the West Virginia Department of Health and Human Resources - a government authority operating within West Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DFA-NEMT-1a?A: DFA-NEMT-1a is a supplement form for the Nemt Reimbursement Program in West Virginia.
Q: What is the Nemt Reimbursement Program?A: The Nemt Reimbursement Program in West Virginia is a program that provides reimbursement for non-emergency medical transportation expenses.
Q: Who can use the DFA-NEMT-1a form?A: The DFA-NEMT-1a form is for individuals who are applying for the Nemt Reimbursement Program in West Virginia.
Q: What information is required on the DFA-NEMT-1a form?A: The DFA-NEMT-1a form requires information such as your name, address, contact details, Medicaid ID, and details of the medical transportation service.
Q: Is there a deadline for submitting the DFA-NEMT-1a form?A: Yes, there is a deadline for submitting the DFA-NEMT-1a form. Please check with the Nemt Reimbursement Program office for the specific deadline.
Q: Can a family member or caregiver submit the DFA-NEMT-1a form on behalf of the applicant?A: Yes, a family member or caregiver can submit the DFA-NEMT-1a form on behalf of the applicant.
Q: How long does it take to process the DFA-NEMT-1a form?A: The processing time for the DFA-NEMT-1a form varies. Please check with the Nemt Reimbursement Program office for an estimate.
Q: Can I appeal if my DFA-NEMT-1a application is denied?A: Yes, you can appeal if your DFA-NEMT-1a application is denied. Contact the Nemt Reimbursement Program office for more information on the appeals process.
Q: Are there any fees associated with the DFA-NEMT-1a form?A: No, there are no fees associated with the DFA-NEMT-1a form.
Form Details:
- Released on June 1, 2009;
- The latest edition provided by the West Virginia Department of Health and Human Resources;
- 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 printable version of Form DFA-NEMT-1a by clicking the link below or browse more documents and templates provided by the West Virginia Department of Health and Human Resources.
Download Form DFA-NEMT-1a Supplement to Application for Nemt Reimbursement Program - West Virginia
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