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SC BlueChoice HealthPlan PF-BSC-0007-14 2014-2025 free printable template

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DILATED RETINAL EYE EXAM COMMUNICATION From This form is to document dilated eye exam results. Place form directly in the member s medical record. Step #1: Patient: Fill out your name, date of birth,
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How to fill out SC BlueChoice HealthPlan PF-BSC-0007-14

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How to fill out SC BlueChoice HealthPlan PF-BSC-0007-14

01
Obtain the SC BlueChoice HealthPlan PF-BSC-0007-14 form from the official website or your local health insurance office.
02
Read the instructions printed on the form thoroughly to understand the required information.
03
Fill in your personal details, including your full name, date of birth, and contact information, in the provided sections.
04
Provide relevant information regarding your medical history as requested on the form.
05
Indicate your preferred coverage options and any additional services you may require.
06
Review all the filled sections for accuracy and completeness before submitting.
07
Sign and date the form at the designated area to validate your application.
08
Submit the completed form via the specified method (online, by mail, or in person) and keep a copy for your records.

Who needs SC BlueChoice HealthPlan PF-BSC-0007-14?

01
Individuals residing in South Carolina looking for health insurance coverage.
02
Families needing comprehensive health plans with specific coverage options.
03
People who may qualify for subsidies or financial assistance for their health insurance.
04
Those who have specific health care needs that can be met through the blue choice options offered.
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People Also Ask about

What is a dilated eye exam? During a dilated eye exam, we use medicated eye drops to open your pupils. Dilating your pupils allows us to see inside each eye to examine your retina, macula, optic nerve, and vitreous in detail.
Bring a list of all of your medications, your insurance cards and pertinent medical history. Allow 1-2 hours for your visit, initial visits may take longer. Additional testing or treatment, such as fluorescein angiography or laser may be indicated following the examination of your eyes.
If an ophthalmologist or optometrist performs an annual dilated eye examination to diagnose, monitor or treat the patient for diabetic retinopathy, HMSA and HPH would prefer that the provider bill using ophthalmological service codes (CPT 92002-92014).
92228: Remote imaging for monitoring and management of active retinal disease (eg, diabetic retinopathy) with physician review, interpretation and report, unilateral or bilateral. 92250: Fundus photography with interpretation and report.
If an ophthalmologist or optometrist performs an annual dilated eye examination to diagnose, monitor or treat the patient for diabetic retinopathy, HMSA and HPH would prefer that the provider bill using ophthalmological service codes (CPT 92002-92014).
Digital retinal imaging technology is non-invasive, and it allows the eye specialist to evaluate the eyes without dilation.

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SC BlueChoice HealthPlan PF-BSC-0007-14 is a specific form or document used for reporting health insurance information related to the BlueChoice HealthPlan in South Carolina.
Providers and organizations that offer or manage health insurance plans under BlueChoice in South Carolina are typically required to file this form.
To fill out SC BlueChoice HealthPlan PF-BSC-0007-14, you should gather the required information, carefully follow the instructions provided on the form, and ensure all sections are completed accurately before submission.
The purpose of SC BlueChoice HealthPlan PF-BSC-0007-14 is to collect and report relevant health insurance information to ensure compliance with regulatory requirements and facilitate the management of health plans.
The information that must be reported on SC BlueChoice HealthPlan PF-BSC-0007-14 includes details about the insured, coverage specifics, claims processed, and any relevant billing information as required by BlueChoice HealthPlan.
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