Get Or Careoregon Health-related Services: Flex Form 2023-2025
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How to use or fill out the OR CareOregon Health-Related Services: Flex Form online
The OR CareOregon Health-Related Services: Flex Form is designed to assist users in requesting flexible funding for health-related services. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to fill out the OR CareOregon Flex Form online.
- Press the ‘Get Form’ button to access the OR CareOregon Health-Related Services: Flex Form and open it for filling out.
- Begin with the 'Request Type' section. Indicate the request type, enter the current date (mm/dd/yyyy), and specify if the request is urgent. If applicable, indicate whether this is a reimbursement request and ensure to attach itemized receipts.
- In the 'Member Information' section, fill in the last name, first name, member ID, date of birth, and whether the member is experiencing houselessness. Provide relevant diagnoses and include appropriate ICD-10 or DSM codes.
- Next, complete the 'Requesting Party Information'. Fill in your name, organization name, office fax, email, and phone number. If different, provide follow-up contact details as well.
- In the 'Request Details and Information' section, complete each field. State the date needed, the quantity of the item or service requested, and the estimated cost. Provide item details and suggest a vendor or payee, if applicable.
- If requesting an air conditioner, select the appropriate unit type and specify the size and room dimensions. Ensure to confirm rental property requirements if applicable.
- Complete the sustainability plan and the treatment care plan connection for the requested item or service. Provide details on any other sources of funding pursued and describe the member's goals.
- Finally, include the requestor's printed name and signature at the end of the form. After verifying all information provided is accurate, proceed to fax the completed form to the specified number.
Begin filling out the OR CareOregon Health-Related Services: Flex Form online today!
Related links form
The health-related services flex fund in Oregon is a resource designed to support individuals in accessing specialized health care services. It is part of the overall framework of the Oregon Health Plan, allowing members to address a variety of health-related needs effectively. The fund serves to enhance health outcomes by providing more flexibility in service options. With the OR CareOregon Health-Related Services: Flex Form, you can navigate these resources comfortably and get the support you need.
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