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Er Making M changges Requ uested Effective Date with CenCal Healtth Provideer Type Specialtty New PCPs complete e section 1 15. New Specialist/Allied/Pharrmacy provideers complete seection 1 11. New DME Proviiders complete e on 1 11 and 15 5. All providerss may use secttion 16 18 for additional a info ormation. sectio Sectiion 1 Provid der Name and d Contact Info ormation Legal Busin.
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Orm FAQ
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Provider Information Form (PIF means the DCBHS approved form that details the clinical and behavioral characteristics of the population that the out-of-home treatment provider is contracted to serve.
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Professional paper claim form (CMS-1500)
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A Position Information Form (PIF) is a description of an employee's actual job duties, minimum level of education, and/or experience typically required to perform those duties with acceptable competence.
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