California Notice Of Predesignation Of Personal Physician

State:
California
Control #:
CA-DWC-9783
Format:
PDF
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Description

Notice Of Predesignation Of Personal Physician California Notice Of Redesignation Of Personal Physician is a document used to designate a personal physician in the State of California. The document must be signed by both the patient and the physician and must be filed with the employee's health plan administrator. It may be used to designate a physician to provide routine and specialty medical care, including diagnosis, treatment, and referrals. There are two types of California Notice Of Redesignation Of Personal Physician: a Notice of Redesignation for HMO's (Health Maintenance Organizations) and a Notice of Redesignation for PPO's (Preferred Provider Organizations). The Notice of Redesignation for HMO's includes a form to be filled out by both the patient and the physician and must be filed with the HMO. The Notice of Redesignation for PPO's includes a form to be filled out by both the patient and the physician, and must be filed with the PPO. Both forms must be signed and dated by both the patient and the physician, and must be kept on file with the health plan administrator.

California Notice Of Redesignation Of Personal Physician is a document used to designate a personal physician in the State of California. The document must be signed by both the patient and the physician and must be filed with the employee's health plan administrator. It may be used to designate a physician to provide routine and specialty medical care, including diagnosis, treatment, and referrals. There are two types of California Notice Of Redesignation Of Personal Physician: a Notice of Redesignation for HMO's (Health Maintenance Organizations) and a Notice of Redesignation for PPO's (Preferred Provider Organizations). The Notice of Redesignation for HMO's includes a form to be filled out by both the patient and the physician and must be filed with the HMO. The Notice of Redesignation for PPO's includes a form to be filled out by both the patient and the physician, and must be filed with the PPO. Both forms must be signed and dated by both the patient and the physician, and must be kept on file with the health plan administrator.

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Dwc Form 9783