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This document provides instructions for selecting a Primary Care Physician (PCP) for paper enrollment in the Humana TotalCare Plan.
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How to fill out physician selection for paper
How to fill out Physician Selection for Paper Enrollment
01
Obtain the Physician Selection form from the enrollment packet.
02
Fill in your personal information at the top of the form, including your name and contact details.
03
Review the list of available physicians and highlight your preferred physician's name.
04
Provide any additional information requested about your medical history or specific needs.
05
Sign and date the form to verify accuracy.
06
Submit the completed form along with your enrollment application.
Who needs Physician Selection for Paper Enrollment?
01
Individuals enrolling in a healthcare plan that requires a designated physician.
02
Patients looking to establish care with a specific healthcare provider.
03
Those transitioning to a new health insurance plan and needing to select a primary care physician.
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What is Physician Selection for Paper Enrollment?
Physician Selection for Paper Enrollment is a process that allows patients to select a primary care physician when enrolling in a healthcare plan using paper forms.
Who is required to file Physician Selection for Paper Enrollment?
Individuals enrolling in a healthcare plan who wish to designate a primary care physician are required to file the Physician Selection for Paper Enrollment.
How to fill out Physician Selection for Paper Enrollment?
To fill out the Physician Selection for Paper Enrollment, individuals must complete the designated form by providing personal information, selecting a primary care physician from the available options, and submitting the form to the healthcare plan.
What is the purpose of Physician Selection for Paper Enrollment?
The purpose of Physician Selection for Paper Enrollment is to ensure that patients have a designated primary care physician to manage their healthcare needs and facilitate the coordination of care.
What information must be reported on Physician Selection for Paper Enrollment?
The information that must be reported on the Physician Selection for Paper Enrollment includes the patient's personal details, selected primary care physician's name, physician's identification number, and any other required demographic information.
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