Get the free CONTINUITY OF CARE REQUEST FORM ATTENTION UTILIZATION

CONTINUITY OF CARE REQUEST FORM ATTENTION: UTILIZATION MANAGEMENT OPERATIONS CENTER MEDICAL: FACSIMILE (301) 388 1637 BEHAVIORAL HEALTH: FACSIMILE (301) 3881638 Welcome to Kaiser Permanent: NAME (Please

How to fill out continuity of care request

How to fill out a continuity of care request:

1. Contact your healthcare provider or insurance company to obtain the necessary forms for a continuity of care request.
2. Fill out the forms accurately and completely, providing all the required information about yourself, your current healthcare provider, and the specialist or healthcare facility you are requesting to continue treatment with.
3. Attach any relevant documentation, such as medical records or referral letters, that support the need for continued care from the specific provider or facility.
4. Review the completed forms for any errors or missing information, ensuring that all sections are properly filled out.
5. Submit the completed continuity of care request to your healthcare provider or insurance company either by mail, email, or through their online portal, as per their preferred method of submission.
6. Keep a copy of the request form and any supporting documents for your records.
7. Follow up with your healthcare provider or insurance company to confirm the receipt of your continuity of care request and to inquire about the status of your request.
8. Be prepared to provide any additional information or answer any questions from your healthcare provider or insurance company, if necessary.
9. Understand that the approval of a continuity of care request is typically determined by your insurance company based on medical necessity and their network guidelines.

Who needs a continuity of care request?

1. Patients who have an ongoing medical condition and are already receiving treatment from a specific healthcare provider or facility may need a continuity of care request if they wish to continue receiving care from the same provider or facility after a change in insurance coverage or network.
2. Individuals who have developed a strong patient-provider relationship with a particular healthcare provider or specialist may also require a continuity of care request if they want to maintain that relationship despite changes in insurance plans or network restrictions.
3. Patients with complex medical conditions or unique healthcare needs may benefit from a continuity of care request to ensure that their specialized treatment continues uninterrupted by insurance changes.

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What is continuity of care request?

Continuity of care request is a formal request made by a patient to ensure uninterrupted care when transitioning between healthcare providers or systems.

Who is required to file continuity of care request?

Patients who are transitioning between healthcare providers or systems are required to file continuity of care request.

How to fill out continuity of care request?

To fill out a continuity of care request, patients need to provide their personal information, current healthcare provider details, requested healthcare provider details, reason for the request, and any relevant medical records.

What is the purpose of continuity of care request?

The purpose of continuity of care request is to ensure that patients receive uninterrupted care during transitions between healthcare providers or systems.

What information must be reported on continuity of care request?

Information such as personal details, current and requested healthcare provider details, reason for the request, and relevant medical records must be reported on continuity of care request.