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1304 Vermilion Street ? Hastings, MN 55033 pH 800-482-3518 ? Fax 651-389-9152 www.edsedi.com MERCY CARE PLAN DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION 86052 PAYER ID NUMBERS
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How to fill out mercy care plan
How to fill out a Mercy Care plan:
01
Obtain the necessary forms: Contact Mercy Care or visit their website to access the required forms for filling out a care plan.
02
Personal Information: Start by providing your personal information, including your full name, date of birth, address, phone number, and email address. This helps Mercy Care identify and communicate with you.
03
Primary care provider (PCP): Indicate the name, contact information, and any other relevant details about your primary care physician. This information allows Mercy Care to coordinate your healthcare services effectively.
04
Medical history: Provide a detailed account of your medical history, including any past diagnoses, medications, surgeries, or ongoing treatments. This information helps Mercy Care understand your specific medical needs.
05
Current health conditions: Discuss any existing health conditions you have, such as diabetes, hypertension, or asthma. Describe your symptoms, severity, and any medications or treatments you are currently receiving.
06
Medications: List all the medications you are taking, both prescribed and over-the-counter. Include the name of the medication, dosage, frequency, and the medical condition it is prescribed for.
07
Allergies: Specify any known allergies or adverse reactions you have had to medications, foods, or other substances. This information is crucial for avoiding any potential allergic reactions or complications in your care plan.
08
Existing healthcare providers: Provide the names and contact information of any specialists (e.g., cardiologist, endocrinologist) you are currently seeing or have seen in the past. This helps Mercy Care coordinate your care and prevents duplication of services.
09
Hospitalizations or emergency room visits: Indicate any recent hospitalizations or emergency room visits you have had. Include the reason for the visit, dates, and any relevant details about the treatment provided.
10
Preferred language and communication needs: Specify your preferred language for communication and any special accommodations you may require, such as interpretation services or accessibility considerations.
Who needs a Mercy Care plan?
A Mercy Care plan is typically required for individuals who are eligible for Mercy Care services. This may include individuals who are enrolled in Medicaid, AHCCCS, or other state-sponsored healthcare programs. Additionally, those who are seeking comprehensive managed healthcare services may also benefit from having a Mercy Care plan.
It is important to note that eligibility requirements and specific criteria may vary based on your location and the program you are enrolled in. It is advisable to consult with Mercy Care or your healthcare provider to determine if a Mercy Care plan is appropriate for you.
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What is mercy care plan?
Mercy care plan is a comprehensive healthcare plan that provides coverage to individuals and families in need of medical assistance.
Who is required to file mercy care plan?
Healthcare providers, insurance companies, and government agencies are required to file mercy care plans.
How to fill out mercy care plan?
Mercy care plans can be filled out online or through a paper application provided by the relevant healthcare authority.
What is the purpose of mercy care plan?
The purpose of mercy care plan is to ensure that individuals have access to necessary medical services and treatments.
What information must be reported on mercy care plan?
Mercy care plans must include information about the individual's medical history, current health status, and prescribed treatments.
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