PM 06-26-12 Correspondence

WAG 06-26-12

The following forms have been updated to reflect the inclusion of the FP program

  •  360C

  -New medical program language including explanation of benefits and approval for Family Planning

 -New denial reasons: Pregnancy

  • REDE forms 1893 & 643

  -Opt In/Opt Out option for Family Planning

  • 2378B*/2378ABE*

 -Opt In/Opt Out option for Family Planning

*Pending update to include FP program as an option