Ansh Tandon
How to Complete the MDHHS-6200 Form 📝
How to Complete the MDHHS-6200 Form 📝
Ansh Tandon
Learn how to complete the MDHHS 6200 Adult Services Medical Needs Certification form for Cova Home Care. This guide explains which sections you need to fill out and how to submit the form to your doctor.
How to Complete the MDHHS-6200 Form 📝
Ansh Tandon
Learn how to complete the MDHHS 6200 Adult Services Medical Needs Certification form for Cova Home Care. This guide explains which sections you need to fill out and how to submit the form to your doctor.
Chapters
00:00
Introduction
Overview of the MDH 6200 form for home care.
00:30
Patient Information
00:47
Signing the Form
01:16
Doctor's Responsibilities
01:39
Submission Process
02:08
Contact and Support
Transcript
00:00
Hi, I'm Ansh and I'm one of the owners at Cova Home Care.
00:03
This video walks you through the MDHHS 6200 form.
00:07
It's called the Adult Services Medical Needs Certification, and it's how the patient's doctor confirms they medically need home help.
00:15
So the good news is almost the entire form is filled out by the doctor and not by you.
00:20
You only need to fill in a few details at the top that we'll go through together.
00:24
And the patient signs once, and it shouldn't take longer than one minute.
00:27
So, as you can see, I've already pre filled in some information.
00:31
And we're going to start with section one.
00:33
So right at the top, there's two fields.
00:35
We need to go ahead and fill in the patient's name right here and then the patient's date of birth right here as follows.
00:43
That's it.
00:44
Just below that, there's a short line authorizing the doctor to share the patient's medical information with the state.
00:50
And there's three things to fill in.
00:52
You need the patient to sign right here.
00:54
You need the patient's printed name over here, and then the date of the signature right here.
01:00
But there is one exception.
01:02
If you as the caregiver have the legal power of attorney for the patient or you're their legal guardian, you can definitely sign for them on their behalf.
01:10
Just write your name and also sign it just as how a patient would normally do it.
01:16
So that's your part done.
01:17
Everything below section one is not for you.
01:20
Section two is for the state's caseworker.
01:23
Section three is for the doctor to fill in.
01:26
It's where they fill in the diagnosis, what the patient needs, help with, equipment, and all of that.
01:33
And then section four is where the doctor signs at the bottom.
01:37
Make sure to leave all of it blank.
01:39
The doctor will handle it.
01:40
So if you go right back to the top, please.
01:43
Once it's signed, take clear photos of the form and message them to us.
01:48
Send us the name and address of the patient's doctor at the same time, and we'll fax it over right away to get the rest filled out.
01:56
But note if the patient has a doctor's appointment coming up soon.
02:00
Please let us know when you send those photos to us.
02:04
And you can bring the paper form with you to that appointment.
02:07
The doctor can fill in their part then and there, which is faster than the fax route.
02:12
And as always, if anything's unclear, please message us and we'll walk through it with you.
02:18
Our phone line is open 24/7 for both text and calls.
02:22
And our phone number is 734-707-7330.
02:29
Thank you very much!