Get the free OHP 3261 Impatient Hospital bHoldb Request for OHP Application - apps state or
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Inpatient Hospital Hold Request for HP Application Hospital Phone Address Fax Contact Person City State ZIP FAX TO: 5033784139 PHONE 18006999075 Use this form only for patients who are admitted for
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How to fill out ohp 3261 impatient hospital
How to fill out ohp 3261 impatient hospital:
01
Start by filling out the patient's personal information, including their full name, date of birth, and contact information.
02
Provide details about the hospital where the patient is being admitted, such as the name, address, and contact information.
03
Indicate the type of admission, whether it is an emergency or a planned procedure. Include the date and time of admission.
04
Specify the reason for hospitalization and any relevant medical conditions or symptoms that led to the decision for inpatient care.
05
Provide information about the referring physician or healthcare professional who recommended the hospital admission.
06
Fill out the insurance details, including the patient's Oregon Health Plan (OHP) identification number and any supplemental insurance coverage.
07
Mention any pre-authorization or prior approval obtained for the hospitalization, if applicable.
08
Include information about the patient's primary care physician and any other healthcare providers involved in their care.
09
Indicate if the patient has any specific requests or preferences related to their hospital stay, such as advanced directives or cultural considerations.
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Review the filled-out form for accuracy and completeness before submitting it to the appropriate department.
Who needs ohp 3261 impatient hospital:
01
Medicaid beneficiaries who are enrolled in the Oregon Health Plan (OHP) and require hospitalization.
02
Patients with medical conditions or symptoms that cannot be adequately managed in outpatient settings and require inpatient care.
03
Individuals who have received a referral from their primary care physician or another healthcare professional for hospital admission due to the severity of their condition or the need for specialized care.
Please note that specific eligibility criteria and requirements may vary, and it is recommended to consult with the Oregon Health Authority or healthcare providers for accurate and up-to-date information regarding the use of ohp 3261 impatient hospital form.
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What is ohp 3261 impatient hospital?
ohp 3261 impatient hospital is a form used to report data on impatient hospital services provided under the Oregon Health Plan.
Who is required to file ohp 3261 impatient hospital?
Hospitals that provide impatient services under the Oregon Health Plan are required to file ohp 3261.
How to fill out ohp 3261 impatient hospital?
ohp 3261 impatient hospital can be filled out online or through a paper form, following the instructions provided by the Oregon Health Authority.
What is the purpose of ohp 3261 impatient hospital?
The purpose of ohp 3261 is to collect data on impatient hospital services provided to Oregon Health Plan members for monitoring and quality improvement purposes.
What information must be reported on ohp 3261 impatient hospital?
Information such as patient demographics, services provided, diagnoses, procedures, and outcomes must be reported on ohp 3261.
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