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PM FORM 10.1.8
BIG EXTENSION, OUTPATIENT, AND OUTCOME
CONCURRENT REVIEW
Member Name :
BIG extension, list dates: from:Date of Review:
to:Outpatient /Out of Home Concurrent Review: Last covered day:
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How to fill out member name
01
Step 1: Start by opening the membership application form.
02
Step 2: Locate the section labeled 'Member Name' or 'Name'.
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Step 3: Fill in your first name in the designated box or field.
04
Step 4: Fill in your last name in the designated box or field.
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Step 5: Double-check your name spelling for accuracy.
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Step 6: If there are any additional boxes or fields for middle names or initials, provide the required details.
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Step 7: Save or submit the filled-out form as per the instructions provided.
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Membership-based services or platforms
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What is member name?
Member name refers to the name of an individual who is part of an organization, group, or team.
Who is required to file member name?
The individual responsible for filing member names is typically an organization's administrator or manager.
How to fill out member name?
Member names can be filled out by entering the individual's full name as it appears on official documents.
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The purpose of member names is to accurately identify and track individuals who are part of an organization or group.
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