Healthcare Documents

The Person-Centered Service Plan Template is designed to help individuals outline their preferences, strengths, goals, and needs while identifying available services. It is used in accordance with Person-Centered Service Planning Guidelines. The template allows users to document necessary details, unmet service needs, and informal supports.

This document is the 2015 catalog and order form for Humana's over-the-counter (OTC) health and wellness products. It provides instructions on how to place an order through RightSource. You will also find information on benefit limits and payment methods.

This file provides detailed instructions on how to renew your nurse aide registration. Follow the step-by-step guide to complete the renewal process efficiently. Ensure you have all the required documents ready before starting the application.

This file is used for enrolling in the RemiStart® Patient Rebate Program for REMICADE® medication. It includes detailed instructions for eligibility and submission. Ensure to fill out all required sections accurately.

This document provides detailed diagnostics and follow-up procedures for economic benefits related to Cafesalud in 2019. It includes methods for organizational development, strategic management, and service auditing. Authors include professionals from various health and administrative backgrounds.

This document provides important instructions for Medicaid enrollment and exchange integration for applicants who may be blind or visually impaired. It includes information on available notice options in alternative formats such as large print, data CD, audio CD, and braille. Additionally, it outlines the availability of applications for benefits administered by the New York State Medicaid Program in accessible formats.

This file contains the Coloplast Care Enrollment form along with sections for Intermittent Catheter, Male External Catheter, Leg & Drainage Bags, and Foley Prescription. It provides detailed instructions for patients and providers to complete the form. It also includes insurance information and the provider's signature.

This file contains the enrollment form for Anthem Blue Cross, including detailed instructions on completing the form and submitting it. The form covers various types of coverage such as medical, dental, vision, and life insurance. It also provides sections for declination, COBRA/Cal-COBRA coverage, applicant's personal information, and prior coverage.

The Dental Provider Manual by Avēsis is essential for validating current pregnancy for Medicaid dental benefits. This guide includes instructions and necessary forms. The Attestation of Pregnancy form must be filled out by the member and their healthcare provider.

This form is used for requesting prior authorization for medical services from UniCare Health Plan of West Virginia. It includes sections for member information, referring provider, servicing provider, and requested service details.

This file is for employees seeking a medical exemption from COVID-19 vaccination in Florida. It includes sections for both the employee and their medical provider to fill out. The completed form must be submitted to the employer to opt-out of a vaccination mandate.

The Springwell Caregiver's Notebook is a comprehensive guide designed to help caregivers keep track of essential information. It includes sections like critical information, care providers, and medication details. The notebook assists in organizing and recording details for better caregiving.