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Get and Sign Wheelchair Repair Form DME 2021-2022
To the manufacturer and the model of the items being requested must be attached. A manufacturer s invoice for any replacement parts may be required to substantiate payment by Medicaid. DME providers are required to educate the recipients on the proper use of durable medical equipment. 9. Itemize all parts requiring replacement and their cost include unaltered complete order form specific to the manufacturer and the model of the items being requested. Per Nevada Medicaid policy intentional...
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