Type of practice medical specialty
[DOC File]SOM - State of Michigan
https://info.5y1.org/type-of-practice-medical-specialty_1_a775fb.html
Duration: _____ hour(s) or _____ day(s) per episode If yes, please explain the care needed by the patient and why such care is medically necessary: Signature of Health Care Provider Date Health Care Provider’s Name and Business Address (Please Print): Type of Practice / Medical Specialty: Telephone: Fax: CS-1840. REV 6/2016
[DOC File]Human Resource Management
https://info.5y1.org/type-of-practice-medical-specialty_1_afe7a2.html
Medical Certification for Family Medical Leave. Important Information about Family Medical Leave . Read this information before you complete the statement regarding care and estimate the time period during which this care will be provided. Include a schedule if leave is to be taken intermittently or on a reduced leave schedule.
[DOT File]New Provider Enrollment Package P for Pediatric sites
https://info.5y1.org/type-of-practice-medical-specialty_1_199d91.html
However, it is our position that an adverse benefit determination based in whole or in part on a medical judgment involving (Specialty) health care treatment must involve a consultation with a board-certified (Specialty) physician in active practice and familiar with this type of treatment.
[DOC File]Specialty Appeal Letters
https://info.5y1.org/type-of-practice-medical-specialty_1_86c9bc.html
Practice demographics, such as location(s), specialty, payer mix, patient population, number of full- and part-time physicians, number of full- and part-time non-physician providers such as nurse practitioners, physician assistants, billing staff and other administrative staff. General description of …
[DOC File]Sample request for proposal (RFP)
https://info.5y1.org/type-of-practice-medical-specialty_1_267ec2.html
Practice Type: Solo Partnership Single Specialty Group Multi-Specialty Group Concierge Model Other: Does your office use Electronic Medical Records? Yes No . Practice Name: Address Primary Address Additional Practice Include this address in health plan directory? Yes No . Mailing Address Credentialing Address If no, Reason: _____ ...
[DOC File]DPA 754
https://info.5y1.org/type-of-practice-medical-specialty_1_61cf3a.html
Type of Practice / Medical Specialty: Telephone: Fax: Page 1 of 2. CS-1837. REV 6/2016. Author: j Last modified by: Keesler, Janet (DTMB) Created Date: 1/2/2009 8:52:00 PM Company:
[DOC File]Certification of Health Care Provider for
https://info.5y1.org/type-of-practice-medical-specialty_1_d3f778.html
8. What is your medical or surgical specialty: What percentage of your practice is dedicated to this specialty? 9. What is your sub-specialty: What percentage of your practice is dedicated to this specialty? 10. Do you limit your practice to the above specialties? _____ Yes _____ No If No, what other specialties do you practice? Provide details ...
[DOC File]PHYSICIANS AND SURGEONS PROFESSIONAL LIABILITY …
https://info.5y1.org/type-of-practice-medical-specialty_1_6cc0ba.html
A “Specialty Provider” is defined as a provider that only serves (1) a defined population due to the practice specialty (e.g., OB/GYN, STD clinic, family planning) or (2) a specific age group within the general population of children ages 0 – 18. Local health departments and pediatricians are not considered specialty providers.
Types of Medical Practices | ACP
Department of Labor regulations for the Family and Medical Leave Act define a “health care provider” as a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife, or clinical social worker, physicians assistant, who is authorized to practice by the State and performing within the scope of their practice as defined by State law, or a …
[DOC File]SOM - State of Michigan
https://info.5y1.org/type-of-practice-medical-specialty_1_c641e6.html
Type of practice/medical specialty: Address: Phone Number: Fax Number: GENETIC INFORMATION NONDISCRIMINATION ACT of 2008 The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual ...
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