Form preview

Get the free Recertification Regarding Tobacco Use - eip sc

Get Form
This document outlines the steps and requirements for a subscriber accused of false certification regarding their tobacco use status for insurance premium adjustments.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign recertification regarding tobacco use

Edit
Edit your recertification regarding tobacco use form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your recertification regarding tobacco use form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing recertification regarding tobacco use online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the guidelines below to benefit from a competent PDF editor:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Upload a document. Select Add New on your Dashboard and transfer a file into the system in one of the following ways: by uploading it from your device or importing from the cloud, web, or internal mail. Then, click Start editing.
3
Edit recertification regarding tobacco use. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.
pdfFiller makes dealing with documents a breeze. Create an account to find out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out recertification regarding tobacco use

Illustration

How to fill out Recertification Regarding Tobacco Use

01
Obtain the Recertification Regarding Tobacco Use form from the appropriate authority.
02
Carefully read the instructions provided on the form.
03
Fill out personal identification information, such as name and contact details.
04
Complete sections regarding your tobacco use status, indicating if you currently use tobacco or have quit.
05
Provide any required documentation or evidence supporting your tobacco use status, if applicable.
06
Review the filled-out form for any errors or omissions.
07
Sign and date the form, confirming that the information provided is accurate.
08
Submit the form to the designated office or online portal as instructed.

Who needs Recertification Regarding Tobacco Use?

01
Individuals who are enrolled in programs or services that require ongoing monitoring of tobacco use.
02
Participants in health insurance plans that offer incentives for non-tobacco users.
03
Patients undergoing certain medical treatments where tobacco use may affect health outcomes.
04
Employees in workplaces with policies regarding tobacco use and cessation programs.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.6
Satisfied
53 Votes

People Also Ask about

When you talk to the billing department, you need to find out which CPT code they billed your tobacco cessation counseling under. Smoking cessation is usually billed as 99405, 99406, or 99407 and which one they use is strictly defined by the amount of time they spent on the counseling.
Smoking Cessation Counseling Codes 99406 and 99407 Each attempt includes a maximum of up to 4 intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of 8 sessions per year. A modifier 25 may be appropriate to append to the primary E/M visit code.
Smoking cessation coding, 99406 and 99407.
What codes are used to bill for these services? G0375—Smoking and tobacco-use cessation counseling visit; intermediate session of more than 3 minutes and up to 10 minutes. G0376—Smoking and tobacco-use cessation counseling visit; intensive session of more than 10 minutes.
ing to the federal Department of Health and Human Services, insurance companies consider folks tobacco users if they use tobacco products – including cigarettes, cigars, pipe tobacco, and chewing tobacco – on average four or more times a week during the past six months.
ICD-10 code Z72. 0 for Tobacco use is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Use the 4Ds to tide over cravings: distract, delay, deep breathing, and drinking water.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Recertification Regarding Tobacco Use is a process that requires individuals to confirm their current tobacco use status for health insurance purposes, often impacting premium rates or eligibility for certain plans.
Individuals who have previously reported their tobacco use status and are enrolled in health insurance plans that require recertification, usually for premium adjustments or health coverage eligibility.
To fill out the Recertification Regarding Tobacco Use form, individuals must provide their current status on tobacco use, typically by selecting options indicating whether they currently use tobacco or have quit.
The purpose is to ensure that insurance providers have up-to-date information on tobacco use, which can affect premium calculations and health management programs.
Individuals must report their current tobacco use status, including specific details such as the type of tobacco products used and the frequency of use, if applicable.
Fill out your recertification regarding tobacco use online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.