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ENCOMPASS FAMILY HEALTH HOMECHILDRENS RECORD AUDIT TOOL Date of Audit: Agency: STANDARD ELIGIBILITY Recent claims and clinical data document the following: Current Medicaid Recipient Copy of Medicaid
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Start by gathering all the necessary information and documents required to fill out the Encompass Family Health Home form.
02
Begin by entering your personal details such as your name, date of birth, address, and contact information.
03
Provide information about your current health insurance coverage, if any.
04
Indicate any existing medical conditions or health concerns that you have.
05
Fill in details about your primary care physician or healthcare provider.
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Answer questions related to your mental health and any behavioral health conditions you may have.
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Provide information about any medications you are currently taking.
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If applicable, provide information about any family members who will also be included in the Encompass Family Health Home.
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Review the completed form for accuracy and completeness before submitting it.
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Submit the filled-out form either online or in person according to the instructions provided.

Who needs encompass family health home?

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Encompass Family Health Home is designed for individuals and families who require coordinated and integrated healthcare services.
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It is particularly beneficial for individuals with complex medical or mental health needs, chronic conditions, or developmental disabilities.
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Encompass Family Health Home may also be suitable for individuals who want a primary care provider who can oversee and coordinate their overall healthcare.
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Encompass family health home is a comprehensive healthcare facility that provides coordinated care for families.
Encompass family health home must be filed by healthcare providers or organizations offering family health services.
To fill out encompass family health home, providers must report patient demographics, medical history, treatment plans, and follow-up care.
The purpose of encompass family health home is to ensure continuity of care and improve health outcomes for families.
Providers must report medical records, prescriptions, lab results, referrals, and patient progress notes on encompass family health home.
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