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Durable Medical Equipment DME Request Form Must Be Filled Out Completely and Legibly Submission of request form required for NY State Marketplace plans Medicaid Child Health Plus and MetroPlus Gold Fax 1. 212. 908. 5185 MetroPlus Member Name Last First M. I. Questions 1. 800. 303. 9626 Patient / Member Information Date of Birth mm/dd/yyyy Name/Title Provider Address City State Information Zip Phone include area code Provider Tax ID Fax include area code Ordering Doctor Name DME Services ICD...
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How to fill out metroplus member name
How to fill out metroplus member name
01
To fill out the metroplus member name, follow these steps:
02
Start by locating the designated field for member name on the metroplus form.
03
Begin by entering the member's first name, followed by the last name.
04
Make sure to correctly capitalize the names as required.
05
If there is a middle name or initial, include it in the appropriate space.
06
Double-check the spelling of the member's name for accuracy.
07
Avoid using abbreviations or nicknames unless specifically instructed.
08
If the member has a suffix (e.g., Jr., Sr., III), include it after the last name.
09
Finally, review the filled-out member name for any errors before submitting the form.
Who needs metroplus member name?
01
Metroplus member name is required for the following individuals:
02
- Individuals applying for Metroplus health insurance coverage.
03
- Current Metroplus members updating their personal information.
04
- Healthcare providers and facilities processing Metroplus insurance claims.
05
- Metroplus customer service representatives assisting members with inquiries or requests.
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What is metroplus member name?
Metroplus member name is the name of the individual who is a member of the MetroPlus Health Plan.
Who is required to file metroplus member name?
The individual who is enrolled as a member of the MetroPlus Health Plan is required to file their member name.
How to fill out metroplus member name?
To fill out the metroplus member name, the individual should provide their full legal name as it appears on their insurance card.
What is the purpose of metroplus member name?
The purpose of metroplus member name is to accurately identify the individual who is covered under the MetroPlus Health Plan.
What information must be reported on metroplus member name?
The information that must be reported on the metroplus member name includes the individual's full legal name and any additional identifying information required by the insurance provider.
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