Form ODM03630 Referral Evaluation for Comprehensive Orthodontic Treatment - Ohio

Form ODM03630 Referral Evaluation for Comprehensive Orthodontic Treatment - Ohio

What Is Form ODM03630?

This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is ODM03630?
A: ODM03630 is a referral evaluation form for comprehensive orthodontic treatment in Ohio.

Q: What is the purpose of ODM03630?
A: The purpose of ODM03630 is to evaluate referrals for comprehensive orthodontic treatment in Ohio.

Q: Who uses ODM03630?
A: ODM03630 is used by orthodontic professionals and providers in Ohio.

Q: What does ODM03630 evaluate?
A: ODM03630 evaluates referrals for comprehensive orthodontic treatment.

Q: Is ODM03630 specific to Ohio?
A: Yes, ODM03630 is specific to Ohio and is used for referrals within the state.

Q: Are there any fees associated with ODM03630?
A: Fees for comprehensive orthodontic treatment may apply, but there is no specific fee associated with the ODM03630 referral evaluation form itself.

Q: Can I fill out ODM03630 on my own?
A: No, ODM03630 is typically filled out by orthodontic professionals and providers after evaluating a referral for comprehensive orthodontic treatment.

Q: Is ODM03630 mandatory for comprehensive orthodontic treatment in Ohio?
A: ODM03630 is required for referrals and evaluations of comprehensive orthodontic treatment in Ohio, but treatment itself is not mandatory.

Q: What should I do if I have questions about ODM03630?
A: If you have questions about ODM03630, it is recommended to contact the Ohio Department of Medicaid or consult with orthodontic professionals and providers in Ohio.

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Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the Ohio Department of Medicaid;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ODM03630 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.

Download Form ODM03630 Referral Evaluation for Comprehensive Orthodontic Treatment - Ohio

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