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FORM A STATEMENT REGARDING THE ACQUISITION OF CONTROL OF OR MERGER WITH A CNAME of CCO: Columbia Pacific CCO, LLC, Jackson County CCO, LLC d/b/a Jackson Care Connect, and Health Share of Oregon1 each

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How to fill out careoregon cco form a

01

Obtain a copy of the CareOregon CCO form A.

02

Fill out the form with accurate and up-to-date information.

03

Make sure to include all required information such as personal details, contact information, and any relevant medical history.

04

Double-check the form for any errors or missing information before submitting it.

05

Submit the completed form to the appropriate CareOregon CCO office or contact person.

Who needs careoregon cco form a?

01

Individuals who are applying for enrollment or seeking services from CareOregon CCO may need to fill out form A.

02

This form may also be required for current members who need to update their information or make changes to their coverage.

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What is careoregon cco form a?

CareOregon CCO Form A is a reporting form used by CareOregon Coordinated Care Organizations.

Who is required to file careoregon cco form a?

Providers and healthcare facilities contracting with CareOregon Coordinated Care Organizations are required to file CareOregon CCO Form A.

How to fill out careoregon cco form a?

CareOregon CCO Form A can be filled out electronically on the CareOregon website or through their designated portal.

What is the purpose of careoregon cco form a?

The purpose of CareOregon CCO Form A is to collect important data on healthcare services provided to members of the CareOregon Coordinated Care Organizations.

What information must be reported on careoregon cco form a?

Information such as member demographics, healthcare services provided, and billing details must be reported on CareOregon CCO Form A.

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