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Attached Document:
pb04-137-ope.pdf
Documents: 2004 Policy Bulletins
#04-137-OPE: Revision To Forms W-299G, W-299J And W-299M
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The purpose of this policy bulletin is to inform staff that the following forms have been revised:
• Notification of Continuing Medicaid Coverage for Children Under 19 Years of Age (W-299G)
• Notification of Regulation on Continuous Medicaid Coverage for Children Under 19 Years of Age (W-299J)
• Fact Sheet for Submission of Documentation for Reimbursement of Paid Medical Bills or Dental Bills (W-299M)
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Created: 11/25/2007
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