CA OptumHealth Facility Application 2016 free printable template
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Opium/OptumHealth Behavioral Solutions of California 1 Facility Network Request Form/Credentialing Application INSTRUCTIONS Read these instructions carefully. It is strongly recommended that an administrative
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How to fill out CA OptumHealth Facility Application
How to fill out CA OptumHealth Facility Application
01
Obtain the CA OptumHealth Facility Application form from the official website or contact OptumHealth directly.
02
Read the instructions carefully to understand the requirements and guidelines for completion.
03
Fill out the applicant information section with accurate details about your facility, including name, address, and contact information.
04
Provide information about the owner(s) of the facility, including their names, titles, and contact information.
05
Complete the business structure section, indicating whether your facility is a corporation, partnership, or sole proprietorship.
06
List the services offered by the facility, ensuring they align with OptumHealth's accepted services.
07
Attach any necessary documentation as required, such as licenses, certifications, and insurance details.
08
Review the application for completeness and accuracy before submission.
09
Submit the completed application to the appropriate OptumHealth office, either electronically or via mail.
Who needs CA OptumHealth Facility Application?
01
Healthcare facilities seeking to partner with OptumHealth for providing services.
02
New or existing facilities looking to expand their network and receive reimbursement for services rendered.
03
Facilities that aim to offer mental health, substance use, or other specialized services under OptumHealth's programs.
04
Organizations that need to gain access to OptumHealth's resources, tools, and support for managing patient care.
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What is CA OptumHealth Facility Application?
The CA OptumHealth Facility Application is a form used by healthcare facilities in California to enroll or update their information with OptumHealth, a part of UnitedHealth Group, which provides various healthcare services and management.
Who is required to file CA OptumHealth Facility Application?
Healthcare facilities, including hospitals, clinics, and any entity that provides medical services in California and wishes to participate in OptumHealth programs, are required to file the CA OptumHealth Facility Application.
How to fill out CA OptumHealth Facility Application?
To fill out the CA OptumHealth Facility Application, applicants need to provide accurate information regarding their facility, including ownership details, types of services offered, and contact information. The application must be completed in its entirety and can typically be submitted online or via mail.
What is the purpose of CA OptumHealth Facility Application?
The purpose of the CA OptumHealth Facility Application is to collect necessary information for the enrollment process of healthcare facilities, allowing them to participate in OptumHealth programs and ensuring compliance with regulatory standards.
What information must be reported on CA OptumHealth Facility Application?
The CA OptumHealth Facility Application requires reporting of information such as the facility's name, address, contact details, ownership structure, licensing information, and the specific healthcare services provided.
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