CA UCSF Benioff Childrens Hospital 7630-034 2017-2025 free printable template
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DIAGNOSTIC IMAGING
REFERRAL FORM
www.childrenshospitaloakland.orgOAKLAND
747 52nd St., #210, Oakland, CA 94609
Hours: Mon Fri 8 am8pm; Sat/Sun 8am1pm
Phone: (510) 4283410 Fax: (510) 9852202
For urgent
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How to fill out CA UCSF Benioff Childrens Hospital 7630-034
01
Obtain the CA UCSF Benioff Children's Hospital 7630-034 form from the hospital's official website or reception.
02
Ensure you have all necessary personal information, including child's name, date of birth, and insurance details.
03
Fill out the parent's or guardian's information, including contact details.
04
Provide detailed medical history and current health concerns of the child.
05
Include emergency contact information as requested on the form.
06
Review the completed form for accuracy and completeness.
07
Submit the form electronically or in person as instructed on the form.
Who needs CA UCSF Benioff Childrens Hospital 7630-034?
01
Children requiring specialized medical care or treatment.
02
Families seeking pediatric healthcare services for their children.
03
Patients referred by primary care physicians for further evaluation or treatment.
04
Anyone who needs access to the facilities and services offered by CA UCSF Benioff Children's Hospital.
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What is CA UCSF Benioff Childrens Hospital 7630-034?
CA UCSF Benioff Children's Hospital 7630-034 is a designation related to hospital billing or documentation specific to pediatric care services provided by UCSF Benioff Children's Hospital in California.
Who is required to file CA UCSF Benioff Childrens Hospital 7630-034?
Providers of pediatric services, including hospitals and healthcare professionals affiliated with UCSF Benioff Children's Hospital, are typically required to file CA UCSF Benioff Children's Hospital 7630-034.
How to fill out CA UCSF Benioff Childrens Hospital 7630-034?
To fill out CA UCSF Benioff Children's Hospital 7630-034, providers should gather all necessary patient and service information, follow the specific guidelines provided with the form, ensure accuracy in reporting, and submit it according to the specified instructions.
What is the purpose of CA UCSF Benioff Childrens Hospital 7630-034?
The purpose of CA UCSF Benioff Children's Hospital 7630-034 is to document and report the pediatric healthcare services rendered, facilitating billing and reimbursement processes, and ensuring compliance with healthcare regulations.
What information must be reported on CA UCSF Benioff Childrens Hospital 7630-034?
The information that must be reported on CA UCSF Benioff Children's Hospital 7630-034 includes patient demographics, nature of services provided, billing codes, dates of service, and additional clinical information as required for accurate processing.
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