Get the free Continuation of Care Request Form - AmeriHealth

Community Care Health Continuity of Care Request Form See instruction for completing this form on the reverse side. ***ATTENTION: You may not need to complete this form*** Complete this form only

How to fill out continuation of care request

How to fill out continuation of care request

1. To fill out a continuation of care request, follow these steps:
2. Begin by gathering all necessary documentation, such as medical records, prescriptions, and any relevant test results.
3. Research and identify the appropriate healthcare provider or facility that you would like to continue your care with.
4. Contact the healthcare provider or facility and inquire about their specific process for requesting continuation of care.
5. Obtain any required forms or application documents from the provider or facility.
6. Carefully fill out the forms, ensuring that all required information is provided accurately.
7. Attach any supporting documentation, such as medical records or test results, to the completed forms.
8. Review the completed request and make sure all necessary information is included.
9. Submit the request to the healthcare provider or facility through their designated submission method, whether it's mailing the forms or submitting them electronically.
10. Follow up with the provider or facility to ensure that your request has been received and is being processed.
11. Keep a copy of the submitted request and any related documents for your records.
12. Await a response from the healthcare provider or facility regarding the approval or denial of your continuation of care request.

Who needs continuation of care request?

1. Continuation of care requests are typically needed by individuals who:
2. - Are transitioning from one healthcare provider or facility to another
3. - Require ongoing medical treatment or care that needs to be continued
4. - Have a chronic or long-term condition that necessitates consistent healthcare services
5. - Need to transfer their medical records and history to a new provider or facility
6. - Are moving to a new location and need to establish healthcare services in that area

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What is continuation of care request?

Continuation of care request is a form used to request the ongoing provision of medical treatment or services beyond a specified period.

Who is required to file continuation of care request?

Healthcare providers are typically responsible for filing continuation of care requests on behalf of their patients.

How to fill out continuation of care request?

Continuation of care requests can typically be filled out online or on paper forms provided by the healthcare provider.

What is the purpose of continuation of care request?

The purpose of continuation of care request is to ensure that patients receive the necessary medical treatment or services without interruption.

What information must be reported on continuation of care request?

Continuation of care requests typically require information such as patient demographics, medical history, current treatment plan, and justification for continued care.