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Plans underwritten by Rocky Mountain HMO (RM HMO) or Rocky Mountain Healthcare Options, Inc. (RICO) Transition of Care Arrange for Primary Care If your current physician participates with Rocky Mountain

How to fill out transition of care

How to fill out transition of care?

1. Gather all pertinent medical information: Collect all medical records, test results, and medication lists to provide a comprehensive overview of the patient's medical history.
2. Identify the healthcare providers involved: Note down the names and contact information of the doctors, specialists, therapists, and any other healthcare professionals who have provided care to the patient.
3. Document current medications and dosage: Detail the patient's current medication regimen, including the name of the medication, dosage, frequency, and any specific instructions or precautions.
4. Provide a summary of the patient's medical condition: Write a clear and concise summary of the patient's current health status, outlining any diagnoses, symptoms, or ongoing treatments.
5. Record recent medical events: Document any recent hospitalizations, emergency room visits, surgeries, or significant changes in the patient's health that may be relevant to their transitional care.
6. Specify any ongoing treatments or therapies: Include information about ongoing treatments, therapies, or rehabilitation programs that the patient is currently undergoing or will require during the transitional care process.
7. Outline the patient's support system: Identify family members, caregivers, or other individuals who play a significant role in the patient's care and should be involved in the transition of care.
8. Include any necessary healthcare directives or legal documents: If the patient has specific healthcare directives, living wills, or power of attorney documents, make sure to include them in the transition of care records.

Who needs transition of care?

1. Patients transitioning from hospital to home: Individuals who are being discharged from the hospital and require continued care, monitoring, or follow-up treatment at home.
2. Patients transferring between healthcare facilities: Individuals who are moving from one healthcare facility to another, such as from a hospital to a rehabilitation center or from a nursing home to a long-term care facility.
3. Patients with chronic or complex medical conditions: Individuals with chronic illnesses, multiple medical conditions, or complex treatment regimens who may benefit from a coordinated transition plan to ensure adequate and appropriate care.
4. Elderly patients with multiple providers: Older adults who receive care from various healthcare providers and specialists, as coordinating their care during transitions can help prevent medication errors and ensure continuity of care.
5. Patients with mental health or behavioral health needs: Individuals with mental health or behavioral health conditions who require specialized care and may need support during transitions between healthcare providers or settings.

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What is transition of care?

Transition of care is the movement of a patient from one setting of care to another.

Who is required to file transition of care?

Healthcare providers and facilities are required to file transition of care.

How to fill out transition of care?

Transition of care can be filled out by providing detailed information about the patient's medical history, current treatment plan, and follow-up care instructions.

What is the purpose of transition of care?

The purpose of transition of care is to ensure the continuity and coordination of care for the patient as they move between different healthcare settings.

What information must be reported on transition of care?

Information such as patient demographics, medical history, current medications, treatment plan, and follow-up care instructions must be reported on transition of care.