Get the up-to-date dma 5118-2024 now

Show details

4 out of 5

23 votes

G*S* 108A-25 and rules adopted by the State of North Carolina* When transportation assistance is provided to a Medicaid recipient for audit purposes it is necessary to document that the individual received a Medicaid covered service from a Medicaid-enrolled provider on the date of transport. Please complete the following This is to certify that Medicaid recipient s name/Medicaid ID Number visited this office or facility on and received a Medicaid covered service. Print Form MEDICAID TRANSPORTAT ...

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

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

Send it via email, link, or fax. You can also download it, export it or print it out.

How to edit Dma 5118 online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making adjustments to your documentation takes only some simple clicks. Make these fast steps to edit the PDF Dma 5118 online free of charge:

Register and log in to your account. Log in to the editor with your credentials or click on Create free account to evaluate the tool’s features.
Add the Dma 5118 for redacting. Click on the New Document option above, then drag and drop the sample to the upload area, import it from the cloud, or using a link.
Modify your file. Make any adjustments needed: add text and pictures to your Dma 5118, highlight information that matters, remove sections of content and replace them with new ones, and add icons, checkmarks, and fields for filling out.
Finish redacting the form. Save the updated document on your device, export it to the cloud, print it right from the editor, or share it with all the people involved.

Our editor is super user-friendly and efficient. Give it a try now!