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Virginia Department of Medical Assistance ServicesMember Choice Form Brain Injury Services Targeted Case Management The Member Choice form is completed by the MCO Care Coordinator following telephonic

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What is member choice form?

The member choice form is a document that allows individuals to select their preferred options regarding certain membership benefits, services, or plans.

Who is required to file member choice form?

Individuals who are enrolled in a specific program or plan that requires selection of benefits or services are required to file the member choice form.

How to fill out member choice form?

To fill out the member choice form, individuals should carefully read the instructions, provide their personal information, select their choices from available options, and submit the form by the specified deadline.

What is the purpose of member choice form?

The purpose of the member choice form is to ensure that members can make informed decisions regarding their benefits and services and to document those choices for the administering organization.

What information must be reported on member choice form?

The member choice form must typically report personal details such as name, contact information, identification numbers, and the selected options pertaining to the benefits or services.

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