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Defense Health Agency
PROCEDURAL INSTRUCTION
NUMBER 8140.01
August 14, 2018,
HIT (J6)/SUBJECT:Acceptable Use of Defense Health Agency Information Technology (IT)References: See Enclosure 1.1. PURPOSE.
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How to fill out dha pi form
How to fill out dha pi
01
To fill out DHA PI (Defense Health Agency, Program Integrity), follow these steps:
02
Obtain the DHA PI form from the official website of the Defense Health Agency.
03
Read the instructions carefully to understand the requirements and guidelines for filling out the form.
04
Provide personal information such as your name, address, contact details, and demographic data as requested.
05
Fill in the medical provider information, including the name and address of the facility or physician you visited.
06
Indicate the date of service and the specific medical procedure, treatment, or medication received.
07
Include any diagnosis or medical condition related to the service provided.
08
Attach any supporting documents or medical records that are required to validate the claim.
09
Review the completed DHA PI form for accuracy and completeness.
10
Sign and date the form to certify the information provided is true and accurate.
11
Submit the filled-out DHA PI form to the designated authority or address mentioned in the instructions.
12
Keep a copy of the form and any supporting documents for your records.
Who needs dha pi?
01
DHA PI (Defense Health Agency, Program Integrity) is required by individuals who have received medical services or treatments within the Defense Health Agency network.
02
This includes active duty military personnel, military retirees, dependents of military personnel, and eligible civilians.
03
Anyone who seeks reimbursement or needs to report medical services received within the DHA network may need to fill out and submit a DHA PI form.
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What is dha pi?
DHA PI stands for Defense Health Agency Privacy Act Issuances.
Who is required to file dha pi?
Healthcare providers and organizations that handle sensitive health information are required to file DHA PI.
How to fill out dha pi?
DHA PI is typically filled out electronically through the designated online portal provided by the Defense Health Agency.
What is the purpose of dha pi?
The purpose of DHA PI is to ensure the protection of sensitive health information and compliance with privacy regulations.
What information must be reported on dha pi?
DHA PI requires reporting of any breaches of sensitive health information, as well as policies and procedures related to the protection of health data.
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