Get the free NC DMA: 8C, Outpatient Behavioral Health Services ... - NC.gov

NC Division of Medical Assistance Orthotics & ProstheticsMedicaid and Health Choice Clinical Coverage Policy No: 5B Amended Date: January 15, 2018Table of Contents 1.0 2.03.04.05.018A25Description

How to fill out nc dma 8c outpatient

How to fill out nc dma 8c outpatient

1. To fill out Form NC DMA 8C Outpatient, follow these steps:
2. Provide your personal information, such as your name, address, and contact details.
3. Fill in the patient details, including the patient's name, date of birth, and Medicaid ID, if applicable.
4. Specify the date and time of the outpatient visit by selecting the appropriate boxes or providing the information in the designated fields.
5. Indicate the type of service or treatment received by the patient during the outpatient visit.
6. Provide the necessary details regarding the healthcare provider, such as their name, address, and provider ID.
7. Enter the diagnosis code and medical procedure code if available.
8. If there are any additional notes or comments related to the outpatient visit, include them in the designated section.
9. Check all the filled information for accuracy and completeness.
10. Sign and date the form to confirm the validity of the provided information.
11. Submit the completed Form NC DMA 8C Outpatient to the relevant authority or healthcare provider.

Who needs nc dma 8c outpatient?

1. The Form NC DMA 8C Outpatient is typically needed by individuals who have received outpatient services or treatments covered by Medicaid in North Carolina. This form is necessary for Medicaid beneficiaries or their authorized representatives to report and seek reimbursement for the provided healthcare services.

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What is nc dma 8c outpatient?

NC DMA 8C outpatient refers to a form used for reporting outpatient services provided by healthcare providers in North Carolina.

Who is required to file nc dma 8c outpatient?

Healthcare providers in North Carolina who offer outpatient services are required to file NC DMA 8C outpatient.

How to fill out nc dma 8c outpatient?

NC DMA 8C outpatient form can be filled out by providing details of the outpatient services provided along with necessary patient information.

What is the purpose of nc dma 8c outpatient?

The purpose of NC DMA 8C outpatient is to report and track outpatient services provided by healthcare providers in North Carolina.

What information must be reported on nc dma 8c outpatient?

Information such as outpatient services provided, patient details, dates of service, and billing information must be reported on NC DMA 8C outpatient.