Get the free Continuation of Care Form - anthem.com

Continuation of Care Form Our goal is to provide benefits for continuity of care for any new member of Anthem Blue Cross and Blue Shield who is receiving prenatal care or is in active treatment, for

How to fill out continuation of care form

How to fill out continuation of care form

1. Open the continuation of care form.
2. Read the instructions carefully.
3. Complete the patient information section by entering the required details such as name, date of birth, address, and contact information.
4. Fill out the medical history section by providing accurate and relevant information about the patient's current and past medical conditions.
5. Include any medications the patient is currently taking.
6. Provide information about any allergies the patient may have.
7. If applicable, specify the reason for the continuation of care and provide details about the previous healthcare provider.
8. Ensure all sections of the form are properly filled out and signed.
9. Double-check the form for any errors or missing information.
10. Submit the completed continuation of care form to the appropriate healthcare provider or organization.

Who needs continuation of care form?

1. Patients who have received care from a previous healthcare provider and are transitioning to a new provider.
2. Individuals who require ongoing medical treatment or management of a chronic condition.
3. Patients who want to ensure continuity of their healthcare by sharing relevant medical information with their new healthcare provider.
4. Individuals who are transferring to a different healthcare facility or organization and need their medical records to be transferred as well.
5. Patients who want to request follow-up care from a healthcare provider after being discharged from a hospital or clinic.
6. Individuals who need to provide their medical history and current health status to a specialist or healthcare professional for consultation or evaluation.

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What is continuation of care form?

Continuation of care form is a document used to ensure ongoing treatment and support for a patient who is transitioning between different healthcare providers or settings.

Who is required to file continuation of care form?

Healthcare providers, such as doctors, hospitals, and clinics, are required to file continuation of care forms.

How to fill out continuation of care form?

Continuation of care form can be filled out by providing detailed information about the patient's medical history, current treatment plan, and any specific needs or preferences.

What is the purpose of continuation of care form?

The purpose of continuation of care form is to ensure that the patient receives consistent and coordinated care as they move between different healthcare providers.

What information must be reported on continuation of care form?

Information such as the patient's medical history, current medications, allergies, and any ongoing treatment plans must be reported on the continuation of care form.