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EXHIBIT C COORDINATING PROVISIONSSTATE/FEDERAL LAW, ACCREDITATION STANDARDS AND GEOGRAPHIC EXCEPTIONS HEALTH SYSTEM IPA WASHINGTON I. INTRODUCTION: Scope: To the extent of any conflict between the
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How to fill out wa health systems ipa:

01
Start by gathering all necessary information and documents such as personal identification, medical history, and insurance information.
02
Access the WA Health Systems IPA form either online or through a healthcare provider.
03
Begin by filling out the patient information section, including your full name, address, phone number, and date of birth.
04
Provide your insurance details, including the name of your insurance provider, policy number, and group number.
05
Fill in your primary care physician's information, including their name, address, and contact details.
06
Next, provide any relevant medical history, including past surgeries, current medications, and any known allergies.
07
If applicable, indicate any preferred healthcare facilities or specialists.
08
Read through the form carefully, ensuring all information is accurate and complete.
09
Once you have reviewed and completed the form, sign and date it.
10
Submit the filled-out WA Health Systems IPA form to the designated recipient, whether it be a healthcare provider or insurance company.

Who needs WA Health Systems IPA:

01
Individuals seeking medical services through the WA Health Systems network may need to fill out the WA Health Systems IPA.
02
Patients who are new to the healthcare network or have changed insurance providers may need to complete this form.
03
Individuals who wish to access specialized medical services or receive care from specific providers within the WA Health Systems network may also need to fill out the IPA form.
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WA Health Systems IPA is a form used for reporting health care information in the state of Washington.
Health care providers and organizations in Washington state are required to file WA Health Systems IPA.
You can fill out WA Health Systems IPA by providing detailed information about your health care services and patient demographics.
The purpose of WA Health Systems IPA is to collect data on health care services provided in Washington to improve health outcomes.
Information such as patient demographics, services provided, and health outcomes must be reported on WA Health Systems IPA.
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