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ADDENDUM 1 TO SOONER CARE PHYSICIAN AGREEMENT FOR CHOICE PRIMARY CARE PROVIDERS/CASE MANAGERS 1.0PURPOSE The purpose of this Addendum (hereafter ADDENDUM 1) is for HCA and PROVIDER to contract for

How to fill out choice physician addendum 1doc

How to fill out choice physician addendum 1doc

1. To fill out the Choice Physician Addendum 1doc, follow these steps:
2. Download the Choice Physician Addendum 1doc form from the official website or obtain a physical copy.
3. Read the instructions and requirements carefully to understand the purpose and proper completion of the form.
4. Fill in your personal information such as name, contact details, and date of birth.
5. Provide your specific choices regarding the medical practitioners you wish to include or exclude from your healthcare network.
6. If applicable, indicate any additional preferences or requirements related to your choice of physicians.
7. Double-check all the information you have provided to ensure accuracy and completeness.
8. Sign and date the form to certify that the information provided is accurate and that you understand the implications of your choices.
9. Submit the completed Choice Physician Addendum 1doc form through the designated submission channel. This could be online, by mail, or in-person depending on the instructions provided.
10. Retain a copy of the filled-out form for your records.

Who needs choice physician addendum 1doc?

1. The Choice Physician Addendum 1doc is typically needed by individuals who have health insurance plans that allow them to select specific physicians to be included or excluded from their network.
2. This form is useful for patients who want to personalize their medical care by choosing specific doctors they prefer or excluding those they do not wish to consult.
3. Insurance policyholders who have the option to customize their healthcare provider list may require this addendum to indicate their preferences accurately.

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What is choice physician addendum 1doc?

The choice physician addendum 1doc is a form used to add or change a primary care physician in a health insurance plan.

Who is required to file choice physician addendum 1doc?

Policyholders or members of a health insurance plan are required to file the choice physician addendum 1doc if they wish to make changes to their primary care physician.

How to fill out choice physician addendum 1doc?

To fill out the choice physician addendum 1doc, one must provide their personal information, current primary care physician details, and the new primary care physician information, if applicable.

What is the purpose of choice physician addendum 1doc?

The purpose of the choice physician addendum 1doc is to ensure that the health insurance plan has updated and accurate information regarding the policyholder's primary care physician.

What information must be reported on choice physician addendum 1doc?

The choice physician addendum 1doc requires information such as the policyholder's name, member ID, current primary care physician details, and new primary care physician information.