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Clinical Coverage Criteria
Extended Care Facility
Document Number: 018Authorization required
Notification within 24 hours of service or
next business day
No notification or authorization
Not coveredCommercialMassHealth×XX
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How to fill out extended care facility

How to fill out extended care facility:
01
Begin by obtaining the necessary paperwork from the facility. This may include admission forms, medical history forms, insurance information, and financial documents.
02
Read through all the forms carefully, making sure to understand the information being asked and any instructions provided.
03
Complete the forms accurately, providing all required information. This may include personal details, emergency contacts, medical conditions, medications, and any specific needs or preferences.
04
If you are unsure about any questions or require assistance, don't hesitate to reach out to the facility staff or ask a family member or advocate for help.
05
Double-check all the information filled in the forms before submitting them. Ensure everything is legible and signed where necessary.
06
If there are any additional documents or supporting materials that need to be included, such as medical records or power of attorney documents, make sure to attach them securely.
07
Return the completed forms to the appropriate person or department as instructed by the facility. Keep a copy of the documents for your records.
08
Follow up with the facility to confirm that your paperwork has been received and processed correctly. This will help ensure a smooth transition to the extended care facility.
Who needs extended care facility:
01
Individuals who require specialized medical care and supervision due to chronic illnesses, disabilities, or long-term health conditions may need an extended care facility.
02
Elderly individuals who can no longer manage their daily living activities independently, such as bathing, dressing, or cooking, may benefit from an extended care facility.
03
Patients recovering from surgeries, injuries, or other medical procedures that require ongoing rehabilitative care and support may be suitable for an extended care facility.
04
Individuals with cognitive impairments, such as Alzheimer's disease or dementia, may require the specialized services and security provided by an extended care facility.
05
Families or caregivers who are unable to provide the necessary level of care and support at home due to various reasons may consider an extended care facility as a suitable option for their loved one's well-being.
Remember to consider individual circumstances and consult with healthcare professionals or experts to determine if an extended care facility is the right choice for your specific situation.
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What is extended care facility?
Extended care facility is a facility that provides long-term care services to individuals who are unable to fully care for themselves.
Who is required to file extended care facility?
Extended care facilities are required to be filed by the facility administrators or owners.
How to fill out extended care facility?
Extended care facility forms can typically be filled out online or submitted in hard copy to the appropriate regulatory agency.
What is the purpose of extended care facility?
The purpose of extended care facility is to ensure that individuals who are unable to fully care for themselves receive the necessary long-term care services.
What information must be reported on extended care facility?
Information such as patient demographics, medical history, treatment plans, and insurance information must be reported on extended care facility forms.
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