Fidelis Care Postpartum Encounter Form (Attachment B) 2016 free printable template
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***THIS FORM MUST BE COMPLETED IN FULL TO BE ELIGIBLE FOR THE PRENATAL/POSTPARTUM INCENTIVE*** BABY CARE PROGRAM PRENATAL/POSTPARTUM ENCOUNTER FORM (Attachment B) Complete this form and submit to
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How to fill out Fidelis Care Postpartum Encounter Form (Attachment B)
01
Start by downloading the Fidelis Care Postpartum Encounter Form (Attachment B) from the official website or request a physical copy from your healthcare provider.
02
Fill out the patient's personal details, including name, date of birth, and contact information at the top of the form.
03
Provide the relevant medical history information, including previous pregnancies and any complications experienced.
04
Indicate the date of the postpartum visit and any relevant details about the delivery.
05
Complete the section regarding the physical examination findings, including vital signs, emotional well-being, and any assessments performed.
06
Document any diagnoses made during the postpartum visit and the corresponding treatment plan.
07
Sign and date the form to verify the information provided and ensure it is ready for submission.
Who needs Fidelis Care Postpartum Encounter Form (Attachment B)?
01
The Fidelis Care Postpartum Encounter Form (Attachment B) is needed by healthcare providers who see postpartum patients, including obstetricians, midwives, and primary care physicians.
02
It is also important for patients who have received postpartum care under Fidelis Care to ensure proper documentation of their visit.
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What is Fidelis Care Postpartum Encounter Form (Attachment B)?
The Fidelis Care Postpartum Encounter Form (Attachment B) is a document used to collect specific information related to postpartum care for members who have recently given birth.
Who is required to file Fidelis Care Postpartum Encounter Form (Attachment B)?
Healthcare providers and facilities that deliver postpartum care to Fidelis Care members are required to file the Postpartum Encounter Form (Attachment B) for the services they provide.
How to fill out Fidelis Care Postpartum Encounter Form (Attachment B)?
To fill out the Fidelis Care Postpartum Encounter Form (Attachment B), providers must accurately complete all required fields with relevant information about the patient, the care provided, and any other specifics as outlined in the form instructions.
What is the purpose of Fidelis Care Postpartum Encounter Form (Attachment B)?
The purpose of the Fidelis Care Postpartum Encounter Form (Attachment B) is to document and report the postpartum care services provided to members, ensuring that they receive appropriate follow-up and support after childbirth.
What information must be reported on Fidelis Care Postpartum Encounter Form (Attachment B)?
The information that must be reported on the Fidelis Care Postpartum Encounter Form (Attachment B) includes the patient's identifying information, date of service, type of care provided, any diagnoses, and outcomes of the visit.
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