Get the free Request for Exception to Monthly Care Coordination Face-to-Face Visits - dhss alaska

This form is used to request an exception to the monthly face-to-face visit requirements for care coordination due to the recipient living in a rural community.

How to fill out request for exception to

How to fill out Request for Exception to Monthly Care Coordination Face-to-Face Visits

1. Obtain the Request for Exception form from your care coordination provider.
2. Read the instructions provided with the form carefully.
3. Fill out your personal information including name, contact details, and member ID.
4. Specify the reason for the exception request clearly and concisely.
5. Include any supporting documents that may strengthen your request.
6. Review your application for completeness and accuracy.
7. Sign and date the form.
8. Submit the request form to your care coordination provider via email, mail, or in person as instructed.

Who needs Request for Exception to Monthly Care Coordination Face-to-Face Visits?

1. Individuals who are unable to attend monthly face-to-face visits due to legitimate reasons such as health issues, transportation challenges, or other extenuating circumstances.

For pdfFiller’s FAQs

What is Request for Exception to Monthly Care Coordination Face-to-Face Visits?

The Request for Exception to Monthly Care Coordination Face-to-Face Visits is a formal process allowing healthcare providers or organizations to seek permission to bypass the standard requirement for in-person visits as part of care coordination, usually due to specific circumstances or patient needs.

Who is required to file Request for Exception to Monthly Care Coordination Face-to-Face Visits?

Healthcare providers or organizations that manage patient care and are obligated to conduct regular face-to-face visits for care coordination are required to file this request if they believe it's necessary to obtain an exception.

How to fill out Request for Exception to Monthly Care Coordination Face-to-Face Visits?

To fill out the Request for Exception, providers should complete the designated form, providing detailed information about the patient, the reason for the request, and any relevant supporting documentation that justifies the exception.

What is the purpose of Request for Exception to Monthly Care Coordination Face-to-Face Visits?

The purpose of the Request for Exception is to allow flexibility in care coordination practices, ensuring that patient care can continue effectively even when in-person visits are not feasible, which can optimize health outcomes.

What information must be reported on Request for Exception to Monthly Care Coordination Face-to-Face Visits?

The information that must be reported includes patient identification details, the reason for requesting the exception, any relevant medical history, and additional information that supports the need for alternative care coordination methods.