Get the up-to-date dhhs form 3400 a-2024 now

Get Form
dhhs form 3400 a Preview on Page 1

Here's how it works

01. Edit your dhhs form 3400 online
01. Edit your dhhs format online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to rapidly redact Dhhs form 3400 a online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Dochub is the greatest editor for updating your paperwork online. Follow this straightforward guide to redact Dhhs form 3400 a in PDF format online at no cost:

  1. Register and log in. Register for a free account, set a secure password, and proceed with email verification to start managing your templates.
  2. Add a document. Click on New Document and select the form importing option: add Dhhs form 3400 a from your device, the cloud, or a secure URL.
  3. Make adjustments to the sample. Utilize the top and left panel tools to edit Dhhs form 3400 a. Add and customize text, images, and fillable fields, whiteout unnecessary details, highlight the important ones, and provide comments on your updates.
  4. Get your documentation completed. Send the sample to other people via email, generate a link for quicker document sharing, export the sample to the cloud, or save it on your device in the current version or with Audit Trail included.

Explore all the benefits of our editor right now!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
What Is DHHS Form 3400-A? This is a legal form that was released by the South Carolina Department of Health and Human Services - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
Benefits: Family Planning is a limited benefit program, which provides coverage for preventive health care, family planning services and family planning-related services. This program does not meet the standard for Minimum Essential Coverage under the Affordable Care Act.
Prior authorization is required for all non-emergent services provided by non-contracted, out-of-state providers.
You can update your contact information over the phone by contacting the Healthy Connections Medicaid Member Contact Center at (888) 549-0820 from 8 a.m. to 6 p.m. Monday through Friday.
be ready to get more

Complete this form in 5 minutes or less

Get form