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Targeted Case Management and Rehabilitative Services Request Form Date of Completion of CANS / NASA Dates of Service Requested Member Name Medicaid Identification Number Primary Diagnosis (if more

How to fill out targeted case management and

How to fill out targeted case management and:

1. Gather all necessary information and documents required for targeted case management. This may include personal identification, medical records, social history, and other relevant paperwork.
2. Complete the demographic information section accurately, providing details such as name, address, contact information, date of birth, and any other requested personal details.
3. Take your time to read and understand each section of the targeted case management form. Ensure you have a clear understanding of the purpose and intention of each question.
4. Provide comprehensive answers to the questions asked, addressing each item thoroughly and accurately. If necessary, seek assistance from a healthcare professional or case manager to ensure you provide the necessary information.
5. Double-check your answers before submitting the form. Ensure that all information is legible and free from errors or omissions.
6. If there are any sections or questions that you do not understand or feel unsure about, do not hesitate to seek clarification from the relevant authorities or professionals.

Who needs targeted case management and:

1. Individuals with complex medical conditions or disabilities that require ongoing assistance and coordination of services may benefit from targeted case management. This could include individuals with chronic illnesses, mental health disorders, developmental disabilities, or substance abuse issues.
2. People who are at risk of being homeless or have unstable housing situations might require targeted case management services to help them access housing resources, financial assistance, and support systems.
3. Individuals who are involved in the criminal justice system or are transitioning from incarceration may benefit from targeted case management to help them reintegrate into society, access necessary services, and reduce recidivism rates.
4. Children and youth with special healthcare needs or who are involved in the foster care system may require targeted case management to ensure their medical, educational, and social needs are met.
5. Aging adults who require assistance in managing their healthcare needs, accessing appropriate community resources, or coordinating long-term care services can benefit from targeted case management.

In summary, targeted case management requires careful completion of the necessary forms, providing accurate and thorough information. It is beneficial for individuals with complex conditions or challenges, including those with medical, housing, criminal justice, or special needs concerns.

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What is targeted case management?

Targeted case management is a service that assists individuals in gaining access to needed medical, social, educational, and other services.

Who is required to file targeted case management?

Healthcare providers and organizations that offer targeted case management services are required to file.

How to fill out targeted case management?

Targeted case management can be filled out electronically or on paper, following the specific guidelines provided by the governing authorities.

What is the purpose of targeted case management?

The purpose of targeted case management is to coordinate services and resources for individuals in need, ensuring they receive the support needed for their well-being.

What information must be reported on targeted case management?

Information such as client demographics, service provided, medical history, and progress made must be reported on targeted case management forms.