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  • Abms 20 2022 6 27 Kh0206q3e4 20 V044 5316375 20220627130132786

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    Victoria lopez
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    This notice informs Victoria Ochoa-Lopez that her request for emergency Medicaid coverage for her daughter requires supporting medical records by July 9th. The agency requests the medical provider submit records to assist with determining coverage. Contact information is provided if she has any questions about the verification request.

    Original Description:

    Kan care

    Original Title

    _ABMS_20_2022_6_27_KH0206Q3E4_20_V044_5316375_20220627130132786

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    This notice informs Victoria Ochoa-Lopez that her request for emergency Medicaid coverage for her daughter requires supporting medical records by July 9th. The agency requests the medical provider submit records to assist with determining coverage. Contact information is provided if she has any questions about the verification request.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    20 views5 pages

    Abms 20 2022 6 27 Kh0206q3e4 20 V044 5316375 20220627130132786

    Uploaded by

    Victoria lopez
    This notice informs Victoria Ochoa-Lopez that her request for emergency Medicaid coverage for her daughter requires supporting medical records by July 9th. The agency requests the medical provider submit records to assist with determining coverage. Contact information is provided if she has any questions about the verification request.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 5

    KanCare Clearinghouse

    PO Box 3599
    Topeka, KS 66601-9738

    Notice Date: 06/27/2022


    Case Name: VICTORIA RAQUEL OCHOA-LOPEZ
    Case Number: 20481551
    VICTORIA R OCHOA-LOPEZ Program: Medical
    2014 S GREEN ST
    WICHITA, KS 67211-5509

    KanCare Verification Request

    We are sending this notice to provide you with more information about recent case action.

    In order to complete your request for SOBRA emergency coverage for VICTORIA OCHOA-LOPEZ our agency
    has requested medical records. This documentation must be received by 7/09/2022.

    To assist, you may contact your medical provider to ask they complete the referral process and send
    supporting documents to the KanCare Clearinghouse. You will be notified by mail once a determination is
    made for your coverage request.

    We provide interpreter services at no cost.

    If you have any questions, please contact KanCare Clearinghouse at 1-800-792-4884 between 8:00 AM and
    5:00 PM Monday through Friday.

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    If you have questions, call KanCare Clearinghouse at (800) 792-4884 between the hours of 8 AM and 5 PM
    Monday through Friday.

    Copies sent to: VICTORIA R OCHOA-LOPEZ

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    Attention: If you speak another language, assistance 日本語 / JAPANESE
    services, free of charge, are available to you. Call 注意事項：日本語を話される場合、無料の言語支援をご
    1-800-792-4884 (TTY: 1-800-792-4292) 利用いただけます。1-800-792-4884 (TTY:
    1-800-792-4292)まで、お電話にてご連絡ください。

    한국어 / KOREAN
    주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무
    료로 이용하실 수 있습니다. 1-800-792-4884 (TTY:
    1-800-792-4292) 번으로 전화해 주십시오.

    中文 / CHINESE РУССКИЙ / RUSSIAN

    注意：如果 使用繁體中文， 可以免費獲得語 Внимание: Если вы говорите на русском языке,


    言援助服務。請致電1-800-792-4884 то вам доступны бесплатные услуги перевода.
    (TTY: 1-800-792-4292) 。 Звоните 1-800-792-4884 (телетайп:
    1-800-792-4292).

    ESPAÑOL / SPANISH
    Atención: si habla español, tiene a su disposición
    servicios gratuitos de asistencia lingüística. Llame
    al 1-800-792-4884 (TTY: 1-800-792-4292).

    FRANÇAIS / FRENCH SWAHILI

    Attention : Si vous parlez français, des services Kumbuka: Ikiwa unazungumza Kiswahili, unaweza
    d'aide linguistique vous sont proposés kupata, huduma za lugha, bila malipo. Piga simu
    gratuitement. Appelez le 1-800-792-4884 1-800-792-4884 (TTY: 1-800-792-4292).
    (ATS: 1-800-792-4292).
    DEUTSCHE / GERMAN TAGALOG

    Achtung: Wenn Sie Deutsch sprechen, stehen Paunawa: Kung nagsasalita ka ng Tagalog, maaari
    Ihnen kostenlos sprachliche Hilfsdienstleistungen kang gumamit ng mga serbisyo ng tulong sa wika
    zur Verfügung. Rufnummer: 1-800-792-4884 nang walang bayad. Tumawag sa 1-800-792-4884
    (TTY: 1-800-792-4292). (TTY: 1-800-792-4292).

    HMOOB / HMONG TIẾNG VIỆT / VIETNAMESE


    Lus Ceev: Yog tias koj hais lus Hmoob, cov kev pab Chú Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ
    txog lus, muaj kev pab dawb rau koj. Hu rau hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số
    1-800-792-4884 (TTY: 1-800-792-4292). 1-800-792-4884 (TTY: 1-800-792-4292).

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