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WISCONSIN DEPARTMENT OF HEALTH SERVICES Division of Public Health F00533 (05/2023)PARTNERSHIP PROGRAM ENROLLMENT INSTRUCTIONS AND IMPORTANT INFORMATIONCompletion of this form is voluntary; however,
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Gather all necessary personal information such as name, address, date of birth, and social security number.
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Individuals who are eligible for both Medicare and Medicaid benefits may need UnitedHealthcare Dual Complete LP.
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UnitedHealthcare Dual Complete LP is a type of Medicare Advantage plan that combines medical and prescription drug coverage for individuals who are eligible for both Medicare and Medicaid.
Healthcare providers who participate in the UnitedHealthcare Dual Complete LP network are required to file the necessary paperwork for reimbursement and claims processing purposes.
Providers can fill out the UnitedHealthcare Dual Complete LP forms electronically or on paper, following the instructions provided by the plan. Detailed information on services rendered and patient demographics must be included.
The purpose of UnitedHealthcare Dual Complete LP is to streamline and coordinate care for individuals who qualify for both Medicare and Medicaid, improving access to healthcare services and reducing administrative burdens.
Providers must report detailed information on the services provided, patient demographics, diagnosis codes, procedure codes, and any other relevant information required for billing and reimbursement purposes.
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