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Of Health reviewer. DOH ID Report Submission Date Health Home and Reporter Information Health Home: Select Health Home Care Management Agency: Population: HHSA HHSC HH Reporter First: HHSC- HCBS HH Reporter Last: Email: Phone: Member Information First: Last: DOB: Enroll Date: CIN: Last Contact Date: Description of Last Contact: Member s Current Location: Pertinent Diagnoses: Incident Information Incident Category: Select Incident Type Occurrence Date/Time: Discovery Date/Time:.

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Medicaid members eligible to be enroll in a Health Home must have: Two or more chronic conditions OR. One single qualifying chronic condition: HIV/AIDS or. Serious Mental Illness (SMI) (Adults) or. Sickle Cell Disease (both Adults and Children) or. Serious Emotional Disturbance (SED) or Complex Trauma (Children)

Who is Eligible to be in a Children's Health Home? Children from birth to age 21 must be enrolled in Medicaid AND meet eligibility criteria by having two or more chronic health conditions (list of chronic conditions) OR one of the following single qualifying conditions: HIV/AIDS. Serious Emotional Disturbance.

A 'Health Home' is not a place; it is a group of health care and service providers working together to make sure you get the care and services you need to stay healthy. Once you are enrolled in a Health Home, you will have your own care manager.

Home Care programs are Medicaid-funded long-term-care programs designed to help eligible elderly or disabled individuals remain safely at home, rather than in a nursing home. Home Care programs have different eligibility requirements, but they all require that you be eligible for Medicaid.

A 'Health Home' is not a place; it is a group of health care and service providers working together to make sure you get the care and services you need to stay healthy. Once you are enrolled in a Health Home, you will have your own care manager.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232