This is a legal form that was released by the North Dakota Department of Health and Human Services - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form SFN708?
A: Form SFN708 is a referral form for the Primary Care Case Management (PCCM) Program in North Dakota.
Q: What is the Primary Care Case Management (PCCM) Program?
A: The Primary Care Case Management (PCCM) Program in North Dakota is a healthcare program that helps eligible individuals receive primary care services.
Q: Who can use Form SFN708?
A: Healthcare providers can use Form SFN708 to refer their patients to the Primary Care Case Management (PCCM) Program.
Q: What information is required on Form SFN708?
A: Form SFN708 requires information such as patient details, provider information, and reason for referral to the Primary Care Case Management (PCCM) Program.
Q: How does the Primary Care Case Management (PCCM) Program work?
A: In the PCCM Program, eligible individuals are assigned a primary care provider who coordinates their healthcare and helps them access necessary services.
Q: What are the benefits of the Primary Care Case Management (PCCM) Program?
A: The PCCM Program helps individuals receive timely and appropriate primary care services, promotes better health outcomes, and reduces healthcare costs.
Q: Who is eligible for the Primary Care Case Management (PCCM) Program?
A: Eligibility for the PCCM Program is based on factors such as income, residency, and medical necessity. It is best to contact the North Dakota Department of Human Services for specific eligibility requirements.
Q: Are there any costs associated with the Primary Care Case Management (PCCM) Program?
A: The PCCM Program may have low or no cost-sharing requirements for eligible individuals, but it is recommended to contact the program for more information on costs.
Q: Can I choose my own primary care provider in the Primary Care Case Management (PCCM) Program?
A: In the PCCM Program, eligible individuals are assigned a primary care provider from a network of participating providers. However, exceptions may be considered for certain situations.
Form Details:
Download a fillable version of Form SFN708 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Health and Human Services.