Get the free DMAP 2410. OHP Newborn Notification Form

Print Clear Form DIVISION OF MEDICAL ASSISTANCE PROGRAMS Office of Client and Community Services Oregon Health Plan Newborn Notification Form Please complete all fields. Blank fields will delay processing.

How to fill out dmap 2410 ohp newborn

How to Fill Out DMAP 2410 OHP Newborn:

1. Begin by downloading the DMAP 2410 OHP newborn form from the relevant website or healthcare provider.
2. Carefully read the instructions provided on the form to understand the required information.
3. Start filling out the form by entering the newborn's personal details, such as name, date of birth, and contact information.
4. Provide the necessary information regarding the newborn's parent or legal guardian, including their names and contact details.
5. Fill in the section that asks for the primary care provider's information, such as their name, address, and phone number.
6. In the following sections, provide information on the newborn's health insurance coverage, including the policy number and the name of the insurance company.
7. If applicable, fill out the section requesting details about any other health insurance coverage the newborn may have.
8. Provide information about any other relevant healthcare programs or benefits that the newborn may be enrolled in.
9. Carefully review the completed form to ensure all information is accurate and up-to-date.
10. Sign and date the form, certifying that the information provided is true and correct.

Who Needs DMAP 2410 OHP Newborn:

1. Oregon residents who have recently given birth to a newborn and are eligible for the Oregon Health Plan (OHP) may need to fill out the DMAP 2410 OHP Newborn form.
2. It is required for parents or legal guardians who wish to enroll their newborn in OHP and ensure they receive the necessary healthcare benefits.
3. The form is specifically designed for individuals who meet the eligibility criteria and want to enroll their newborn in the Oregon Health Plan, a state-sponsored healthcare program.

For pdfFiller’s FAQs

What is dmap 2410 ohp newborn?

DMAP 2410 OHP Newborn is a form used for reporting the birth of a newborn child to the Oregon Health Plan (OHP) within the Department of Human Services.

Who is required to file dmap 2410 ohp newborn?

Parents or legal guardians of the newborn child are required to file DMAP 2410 OHP Newborn form.

How to fill out dmap 2410 ohp newborn?

The DMAP 2410 OHP Newborn form must be completed with the required information such as the newborn's name, date of birth, and parental information.

What is the purpose of dmap 2410 ohp newborn?

The purpose of DMAP 2410 OHP Newborn form is to enroll the newborn child in the Oregon Health Plan (OHP) and ensure access to healthcare services.

What information must be reported on dmap 2410 ohp newborn?

The DMAP 2410 OHP Newborn form requires information such as the newborn's name, date of birth, parent's names, and contact information.

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