Dma 5048-2025

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The document is a Medicaid Transportation Exception Verification form used by beneficiaries to request transportation assistance outside the normal service area or for special needs. It includes sections for identifying information, beneficiary consent to release information, justification for exceptions, and provider attestation. The form must be completed accurately to avoid delays in transportation services.

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Click ‘Get Form’ to open the dma 5048 in the editor.
Begin with Section 1, where you will find fields for identifying information. Fill in the County Department of Social Services, date, beneficiary name, address, phone number, Medicaid ID, caseworker name, and caseworker phone.
Move to Section 2 for Medicaid Beneficiary Consent. Enter the beneficiary's name and authorize the medical provider to release necessary information by filling in their details. Ensure the signature and date are completed.
In Section 3, specify any exceptions requested. Indicate if transportation is needed outside the normal service area or if a special mode of transportation is required. Provide justifications and details as necessary.
Complete Section 4 by having the provider print their name, sign, and provide their contact information along with the date.

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Versions	Form popularity	Fillable & printable
2022	4.6 Satisfied (22 Votes)
2018	4.7 Satisfied (41 Votes)
2015	4.8 Satisfied (56 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the number for Medicaid transportation in NC?

For information about your ride after you set it up, call Ride Assist at 855-397-3602. Use this number to activate a Will Call pickup, or if your transportation is late for a scheduled pickup. Use this number, too, if you need to make a change or cancel a previously scheduled reservation.

What is NC DHHs DMA?

Division of Medical Assistance manages the North Carolina Medicaid and Health Choice for Children programs. Medicaid. provides health insurance for low-income children, families of dependent children, pregnant women, seniors, and.

Is NC Medicaid Direct the same as Medicaid?

NC Medicaid Direct is North Carolinas health care program for NC Medicaid beneficiaries who are not enrolled in NC Medicaid Managed Care. It includes care management by Community Care of North Carolina (CCNC), the primary care case management entity for physical health services.

What does NCDHHS do?

The Department of Health and Human Services manages the delivery of health- and human-related services for all North Carolinians, especially our most vulnerable people children, elderly, disabled and low-income families.

What is North Carolinas DMA?

The North Carolina Division of Medical Assistance (DMA) manages the Medicaid and Health Choice programs. Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.

dma 5048

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What does DMA stand for in medical terms?

DIPLOMA IN MEDICAL ASSISTING (DMA) PROGRAM DESCRIPTION. The Medical Assisting program provides didactic and in-the-field learning experiences that will enable students to enter the workforce as entry-level medical assistants. Students will be qualified to work as a Clinical or Administrative Medical Assistant.

Dma 5048-2025

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What is the number for Medicaid transportation in NC?

What is NC DHHs DMA?

Is NC Medicaid Direct the same as Medicaid?

What does NCDHHS do?

What is North Carolinas DMA?

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What does DMA stand for in medical terms?

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