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Molina Healthcare of California
Marketplace
Prior Authorization/PreService Review Guide
Effective: 01/01/2014
This Prior Authorization/PreService Guide applies to all Molina Healthcare Marketplace
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How to fill out office visits to contracted

How to fill out office visits to contracted:
01
Gather necessary documentation: Collect all relevant paperwork such as medical records, referral forms, and insurance information.
02
Verify patient information: Ensure that all patient details are accurate and up-to-date, including name, contact information, and insurance coverage.
03
Complete patient demographics: Fill in demographic information such as age, gender, address, and any applicable identification numbers.
04
Record reason for visit: Document the primary reason why the patient is seeking medical care during the office visit. Include specific symptoms or concerns.
05
Document medical history: Record any pertinent past medical conditions, surgeries, allergies, or medications that the patient is currently taking.
06
Conduct a thorough physical examination: Document the findings of the physical examination, including vital signs, observations, and any abnormal or noteworthy findings.
07
Order additional tests or procedures if necessary: If further tests or procedures are required, indicate the specific tests to be ordered and provide any additional instructions.
08
Consultation and treatment plan: Discuss with the patient the diagnosis, treatment options, and any recommended medications or follow-up visits. Document the agreed-upon plan.
09
Obtain necessary signatures: If required, ensure that the patient or legal guardian signs any consent forms or agreements related to the office visit.
Who needs office visits to contracted:
01
Patients who are covered under specific insurance contracts: Office visits to contracted refer to visits that are covered by a specific contract between a healthcare provider and an insurance company. Therefore, individuals who are insured under such contracts are eligible for office visits to contracted.
02
Individuals requiring routine medical care: Office visits to contracted are commonly used for routine check-ups, preventive care, or general medical consultations for various health concerns.
03
Patients with chronic conditions or specific health issues: Office visits to contracted may be necessary for individuals with chronic health conditions that require regular monitoring or specific medical attention.
It is important to note that the exact eligibility criteria and coverage may vary depending on the specific healthcare provider, insurance plan, and contractual agreements. It is always recommended to check with the healthcare provider or insurance company for clarification on office visit coverage.
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What is office visits to contracted?
Office visits to contracted are visits by an individual to a contracted office or location.
Who is required to file office visits to contracted?
The individual who visited the contracted office or location is required to file the office visits to contracted.
How to fill out office visits to contracted?
Office visits to contracted can be filled out by providing details such as date of visit, purpose of visit, duration of visit, and any relevant observations.
What is the purpose of office visits to contracted?
The purpose of office visits to contracted is to track and monitor interactions with contracted offices or locations for record-keeping and compliance purposes.
What information must be reported on office visits to contracted?
Information such as date of visit, purpose of visit, duration of visit, location visited, and any relevant observations must be reported on office visits to contracted.
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