Form H1063, Request for Review Outcome Letter

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Documents

Effective Date: 9/2013

Availability

Note: This is a secure form and is not available through this site.  The Form H1063 will be sent to CHIP or CHIP perinatal households that request a review.  The form provides the final outcome of the review for review.  H1063 will only be accessible to the HHSC request for review staff.