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February2016 LACMA Medical Specialty Mental Health Services FeeforService Individual or Group Contract Checklist You will be eligible to begin providing services and receive reimbursement only after
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How to fill out lacdmh medi-cal specialty mental

01
Step 1: Gather all necessary information and documents required for filling out the LACDMH Medi-Cal specialty mental health application.
02
Step 2: Visit the official website of LACDMH or contact their office to obtain the application form.
03
Step 3: Carefully read the instructions provided with the application form to understand the requirements and process.
04
Step 4: Fill out the application form accurately and completely. Provide all the requested information, including personal details, income information, and mental health treatment history.
05
Step 5: Attach any required supporting documents, such as proof of income, proof of residence, and any relevant medical records or letters from healthcare professionals.
06
Step 6: Review the completed application form and make sure all information and attachments are included.
07
Step 7: Submit the application form and supporting documents either by mail or in person at the designated LACDMH office.
08
Step 8: Follow up with LACDMH to check the status of your application and provide any additional information or documentation if requested.
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Step 9: Once your application is processed and approved, you will receive notification from LACDMH regarding your Medi-Cal specialty mental health coverage.

Who needs lacdmh medi-cal specialty mental?

01
Individuals who have a diagnosed mental health condition and require specialized mental health services.
02
Individuals who qualify for Medi-Cal assistance based on their income and other eligibility criteria.
03
Individuals who reside in the Los Angeles County area, as LACDMH specifically serves this location.
04
Individuals who may be uninsured or underinsured and need access to affordable mental health care.
05
Individuals who meet the specific requirements set by LACDMH for their specialty mental health program.

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