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COUNTY: MENDOCINO PROVIDER TYPENAMEADDRESSOPTOMETRIST OPTOMETRIST OPTOMETRISTLYNETTE KLINE O.D. SMITH, J KYLE OD WOLFMAN, ELIAS O.D.510 CYPRESS STREET STE A 450 N McPherson ST 139 LAUREL STF ORT BRAGG

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How to fill out medi-cal fee-for-service vision provider

01

To fill out the Medi-Cal Fee-For-Service Vision Provider, you need to follow these steps:

02

Gather all necessary information, including your Medi-Cal provider number, contact details, and the patient's information.

03

Fill out the provider section with your personal details and provider information.

04

Provide the patient's details, including their name, address, and date of birth.

05

Specify the vision services provided and the applicable procedure codes.

06

Enter the date and duration of the services provided.

07

Include any additional information or comments that may be relevant.

08

Sign and date the form to certify the accuracy of the information provided.

09

Submit the completed form to the appropriate Medi-Cal office for processing.

10

Who needs medi-cal fee-for-service vision provider?

01

Medi-Cal Fee-For-Service Vision Provider is needed by individuals who have Medi-Cal insurance and require vision-related services.

02

This includes individuals who need eye examinations, glasses, contact lenses, and other vision-related treatments.

03

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What is medi-cal fee-for-service vision provider?

Medi-Cal fee-for-service vision provider is a provider that offers vision services to Medi-Cal beneficiaries on a fee-for-service basis.

Who is required to file medi-cal fee-for-service vision provider?

Any vision provider who offers services to Medi-Cal beneficiaries on a fee-for-service basis is required to file as a Medi-Cal fee-for-service vision provider.

How to fill out medi-cal fee-for-service vision provider?

To fill out the Medi-Cal fee-for-service vision provider form, providers must report all relevant information about the vision services rendered to Medi-Cal beneficiaries.

What is the purpose of medi-cal fee-for-service vision provider?

The purpose of the Medi-Cal fee-for-service vision provider program is to ensure that Medi-Cal beneficiaries have access to necessary vision services in a fee-for-service model.

What information must be reported on medi-cal fee-for-service vision provider?

Providers must report information such as the type of vision services rendered, date of service, beneficiary information, and any relevant billing codes.

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