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COVID-19 Telehealth Program ApplicationFiling Instructions OMB Control No. 3060 12711Contents COVID-19 Telehealth Program Overview .....................................................................................................

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How to fill out covid-19 telehealth program

01

Step 1: Contact your healthcare provider to inquire about their telehealth program for covid-19

02

Step 2: Provide your personal information including name, date of birth, and contact details

03

Step 3: Schedule a telehealth appointment with your healthcare provider

04

Step 4: Follow the instructions provided by your healthcare provider during the telehealth appointment

05

Step 5: Ask any questions or concerns you may have regarding covid-19 during the telehealth appointment

Who needs covid-19 telehealth program?

01

Individuals who are experiencing covid-19 symptoms

02

Individuals who have been exposed to someone with covid-19

03

Individuals who are at high risk for severe illness from covid-19

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What is covid-19 telehealth program?

Covid-19 telehealth program is a program that allows individuals to receive healthcare services remotely through telecommunications technology.

Who is required to file covid-19 telehealth program?

Healthcare providers who offer telehealth services for covid-19 related care are required to file covid-19 telehealth program.

How to fill out covid-19 telehealth program?

To fill out covid-19 telehealth program, healthcare providers need to provide information about the telehealth services they offer for covid-19, including patient demographics, types of services provided, and billing information.

What is the purpose of covid-19 telehealth program?

The purpose of covid-19 telehealth program is to track and report telehealth services provided for covid-19 related care, and ensure that patients have access to remote healthcare during the pandemic.

What information must be reported on covid-19 telehealth program?

Information that must be reported on covid-19 telehealth program includes patient demographics, types of telehealth services provided, dates of services, and billing details.

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