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Send doh form 4359 via email, link, or fax. You can also download it, export it or print it out.
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Click ‘Get Form’ to open the doh 4359 in the editor.
Begin by filling out the Patient Identifying Information section. Enter the patient's name, CIN, address, telephone number, Medicare number, and date of birth. If currently hospitalized, provide the hospital name and discharge details.
In the General Information section, input the physician's name, license number, and contact details. If applicable, include information about any assistants involved in the examination.
Proceed to Medical Findings. Document height and weight, primary and secondary diagnoses with ICD-9-CM codes. Describe the patient's current condition and treatment plan while indicating any limitations or special needs.
Complete the final sections regarding medication administration and contributing factors affecting home care needs. Ensure all fields are filled accurately to avoid delays.
Finally, have the physician sign and date the form before submitting it to ensure compliance with regulations.
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How does the consumer directed personal assistance program work?
Consumers enrolled in the CDPAP program are allowed to manage their own care by recruiting, hiring, training, supervising, scheduling and dismissing their own personal assistants. Instead of a home care agency controlling the personal assistants, the Consumer takes on the role of employer for the personal assistants.
What is the consumer directed personal assistance program?
The program allows people who are Medicaid-eligible to have more control over who provides their home care and how it is provided. Consumers enrolled in the CDPAP program are allowed to manage their own care by recruiting, hiring, training, supervising, scheduling and dismissing their own personal assistants.
What is a doh form?
This form provides consent for enrollment in a Health Home and for the purpose of. sharing health information for individuals who are 18 years of age or older or are under the age of 18 AND a parent, pregnant, or married.
What is the difference between PPO and consumer directed?
Office Copays - The CDHP plan includes copayments for non-diagnostic services, such as office visits. Unlike a traditional PPO, however, there are no copays until the deductible is met. All charges are applied to the deductible. This information is detailed in the summary plan description.
doh 4359 form
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People also ask
How do consumer directed services work?
Consumer Directed Services is an innovative program that gives individuals greater control over their own care. By allowing individuals to choose and manage their own personal care assistants, CDS provides a more flexible and cost-effective solution for those who require assistance with daily activities.
How much does the consumer directed personal assistance program pay in Texas?
As of Mar 8, 2025, the average annual pay for a Cdpap in Texas is $43,358 a year. Just in case you need a simple salary calculator, that works out to be approximately $20.85 an hour. This is the equivalent of $833/week or $3,613/month.
doh form
Geographic Variation in Hospital Admission Rates in the
Health care expenditures continue to steadily increase with hospital stays making up about one- third of health care expenditures.
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