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Get Ca Dhcs Form Mc 330 2015-2026
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How to fill out the CA DHCS Form MC 330 online
Completing the CA DHCS Form MC 330 is essential for reporting the birth of a child to Medi-Cal. This guide will provide you with clear, step-by-step instructions on how to fill out the form online to ensure a smooth submission process.
Follow the steps to fill out the CA DHCS Form MC 330 correctly.
- Press the ‘Get Form’ button to access the CA DHCS Form MC 330 and open it in the online editor.
- In Section A, enter the mother's name (first, middle initial, last), date of birth, BIC or SSN, mailing address, city, county, state, ZIP code, and telephone number.
- In Section B, provide the name of each newborn (first, middle initial, last), date of birth (month/day/year), and gender (select Male or Female). Repeat this for each newborn, including optional BIC numbers.
- Indicate where the newborn was born by providing the hospital or clinic name and its address if available. Include the state, city, and ZIP code.
- In Section C, if applicable, fill in details of the person completing the form on behalf of the parent, including their name, title, NPI number, and telephone number.
- Review all provided information for accuracy. After confirming that everything is correctly filled out, proceed to save changes, download, print, or share the completed form as needed.
Complete your CA DHCS Form MC 330 online today for a seamless submission process.
The Department of Health Care Services (DHCS) is the state agency responsible for overseeing health care services in California. Its mission includes providing access to quality health care for eligible populations through programs like Medi-Cal. For individuals seeking to navigate the application process, utilizing the CA DHCS Form MC 330 can be a streamlined solution for accessing necessary services.
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