Get the free CalOptima Pregnancy Notification Report (PNR)
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Today's Date: Optima Pregnancy Notification Report (PNR) FAX or EMAIL to Optima Case Management Department at 7142468677 or PRS cal optima.org A risk assessment profile must be performed on all pregnant
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How to fill out caloptima pregnancy notification report
How to fill out caloptima pregnancy notification report
01
Obtain the CalOptima Pregnancy Notification Report form.
02
Fill out the patient's personal information, including their full name, date of birth, address, and phone number.
03
Provide the patient's Medi-Cal ID number and their primary care physician's name and contact information.
04
Indicate the date of the pregnancy confirmation and the estimated due date.
05
Fill out any additional relevant information, such as previous pregnancies or medical conditions.
06
Ensure that the form is signed by the patient or their authorized representative.
07
Submit the completed form to CalOptima according to their specific instructions.
Who needs caloptima pregnancy notification report?
01
Any pregnant individual who is eligible for Medi-Cal benefits and is covered by CalOptima healthcare provider network needs to fill out the CalOptima Pregnancy Notification Report.
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What is caloptima pregnancy notification report?
CalOptima pregnancy notification report is a form that must be completed by individuals who are pregnant and enrolled in CalOptima health insurance.
Who is required to file caloptima pregnancy notification report?
Pregnant individuals who are enrolled in CalOptima health insurance are required to file the pregnancy notification report.
How to fill out caloptima pregnancy notification report?
The CalOptima pregnancy notification report can be filled out online through the CalOptima website or by requesting a paper form from CalOptima customer service.
What is the purpose of caloptima pregnancy notification report?
The purpose of the CalOptima pregnancy notification report is to inform CalOptima of pregnancies so that appropriate care and services can be provided to the expectant mother.
What information must be reported on caloptima pregnancy notification report?
The CalOptima pregnancy notification report typically requires information such as the expectant mother's name, contact information, expected due date, and any relevant medical history.
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