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AETNABETTERHEALTHOFOHIO
MyCareOhioOhioContinuityofCare/TransitionofCareRequirements
Duringthetransitionperiod, changefromtheexistingprovidercanonlyoccurinthefollowingcircumstances:
1. Whenammemberrequestsachange;
2.
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How to fill out formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicar
01
The form "formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicareormedicaidor" should be filled out by healthcare providers who have made the decision to discontinue providing services to a member who is currently covered by Medicare or Medicaid.
02
The first step in filling out this form is to gather all the necessary information. This includes the provider's name, contact information, and Medicare or Medicaid provider number.
03
Next, the reason for discontinuing services to the member should be clearly stated. This could be due to various reasons such as relocation, retirement, or any other valid reason as allowed by Medicare or Medicaid guidelines.
04
The form should also include the effective date of the service discontinuation. This is important for ensuring a smooth transition for the member to find alternative healthcare providers.
05
It is crucial to provide any supporting documentation or evidence that may be required to support the decision to discontinue services. This can include medical records, correspondence with the member or their representative, or any other relevant documentation.
06
Once all the necessary information has been gathered, the form should be filled out accurately and completely. It is important to review the form for any errors or omissions before submitting it.
07
Finally, the completed form should be submitted according to the instructions provided by the relevant Medicare or Medicaid authority. This may involve mailing the form to a specific address or submitting it electronically through an online portal.
08
It is important to keep a copy of the completed form for the provider's records and to ensure that proper documentation is maintained throughout the process.
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What is formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicareormedicaidor?
The form is used when a provider chooses to discontinue providing services to a member as currently allowed by Medicare or Medicaid.
Who is required to file formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicareormedicaidor?
The provider who is choosing to discontinue services for a member as currently allowed by Medicare or Medicaid is required to file the form.
How to fill out formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicareormedicaidor?
The form should be filled out with the relevant information regarding the member, the services being discontinued, and the reasons for discontinuation.
What is the purpose of formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicareormedicaidor?
The purpose of the form is to notify the appropriate entities that a provider is choosing to discontinue services for a member as currently allowed by Medicare or Medicaid.
What information must be reported on formproviderchoosestodiscontinueprovidingservicestoamemberascurrentlyallowedbymedicareormedicaidor?
The form must include information about the member, the specific services being discontinued, and the reasons for discontinuation.
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