Loading
Get Or Careoregon Health-related Services: Flex Form 2019-2025
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to use or fill out the OR CareOregon Health-Related Services: Flex Form online
Filling out the OR CareOregon Health-Related Services: Flex Form is an essential process for users seeking health-related services funding. This guide provides step-by-step instructions to ensure accurate and efficient completion of the form online, helping you navigate through the necessary sections with ease.
Follow the steps to successfully complete the Flex Form.
- Click the ‘Get Form’ button to obtain the document and open it in your preferred editor.
- Start by entering the date of your request in the appropriate format: month, day, and year.
- Indicate your CCO (Coordinated Care Organization) by selecting from the provided options.
- Select the type of request you are submitting, either 'Flex Request' or 'K Plan Letter.' If you are requesting a K Plan letter, complete only the first page as detailed in the form.
- Fill out the member information section by providing the full name, DMAP number or Member ID, date of birth, primary diagnosis, and any additional diagnoses for the member.
- Complete the requesting party information to identify who is filling out the form. Include your name, email, fax number, and phone number.
- In the request details section, clearly list the item or service being requested, along with the date needed, estimated cost, and suggested vendor(s).
- Acknowledge that these funds are a last resort by completing the necessary statement. Attach any supporting documentation that details the pursuit of community or third-party resources.
- Describe the member's treatment plan, explaining how the requested item or service aligns with this plan.
- Outline the sustainability plan, detailing how the member will manage after the item/service is secured and what follow-up actions will be taken.
- Print and sign the form in the designated area for the primary care team, ensuring it is properly completed.
- Once all sections are filled out accurately, save your changes, and then download, print, or share the form as necessary. Submit completed forms via fax, secure email, or mail as instructed.
Complete your OR CareOregon Health-Related Services: Flex Form online today!
To request flex funds, you can contact CareOregon at 1-866-540-7202. Their representatives are ready to assist you in processing your request related to OR CareOregon Health-Related Services: Flex Form. Make sure to have your membership details at hand for a smoother experience.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.