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PO Box 336Phone: 6208462286 Fax: 8888790324Montezuma KS 67867Email: membersupport@cha.faithDirect Primary Care Enrollment Form The DPC program will share 50% of Direct Primary Care charges in monthly
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How to fill out direct primary care enrollment
How to fill out direct primary care enrollment
01
Research direct primary care providers in your area.
02
Contact the provider to inquire about enrollment procedures.
03
Fill out any required enrollment forms, which may include personal information and medical history.
04
Review and sign the membership agreement, understanding the fees and services included.
05
Make the initial payment, if required, to secure your membership.
Who needs direct primary care enrollment?
01
Individuals seeking more personalized and accessible primary care services.
02
Those who want to establish a long-term relationship with a primary care provider.
03
People looking for a more cost-effective and transparent healthcare option.
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What is direct primary care enrollment?
Direct primary care enrollment is a model of healthcare where patients directly contract with primary care providers for services, bypassing traditional insurance models.
Who is required to file direct primary care enrollment?
Typically, individuals opting for direct primary care services, as well as primary care providers participating in direct primary care agreements, are required to file for enrollment.
How to fill out direct primary care enrollment?
To fill out direct primary care enrollment, individuals must complete a specified enrollment form provided by the primary care provider, ensuring all required personal and health information is accurately recorded.
What is the purpose of direct primary care enrollment?
The purpose of direct primary care enrollment is to formalize the patient-provider relationship and streamline access to primary care services without insurance intermediaries.
What information must be reported on direct primary care enrollment?
Information typically required includes the patient's personal details, insurance status (if any), contact information, and any agreed-upon direct primary care fees.
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