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CA Magellan Healthcare Bridge to Home Coordination Form 2018-2026 free printable template

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Bridge to Home Coordination FormPROPRIETARY Magellan HealthcareDischarge Date: Last Covered Date: Followup Appointment Date: Please fax completed form to: WHA Fax: 8886564789 OR BSC Fax: 8886560467
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How to fill out CA Magellan Healthcare Bridge to Home Coordination

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How to fill out CA Magellan Healthcare Bridge to Home Coordination Form

01
Begin with patient identification: Fill in the patient's full name, date of birth, and insurance information.
02
Provide contact information: Include the patient's current address, phone number, and email address.
03
Indicate the reason for the transition: Specify whether it is due to discharge from a facility, a change in health status, or other reasons.
04
Complete the medical history: Include relevant medical diagnoses, current medications, and any allergies.
05
Describe the patient's needs: Detail the necessary medical equipment, therapies, or assistance required post-transition.
06
List the care team: Include names and contact information of healthcare providers involved in the patient's care.
07
Note any special instructions: Provide additional information or instructions important for the patient's care.
08
Review for accuracy: Ensure all information entered is complete and accurate before submitting the form.

Who needs CA Magellan Healthcare Bridge to Home Coordination Form?

01
Patients transitioning from a healthcare facility to home care.
02
Caregivers or family members of patients who need coordination of services.
03
Healthcare providers coordinating post-discharge care plans.
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The CA Magellan Healthcare Bridge to Home Coordination Form is a document designed to facilitate the smooth transition of patients from hospital to home healthcare services, ensuring that all necessary information is communicated effectively.
Healthcare providers and case managers involved in the discharge planning process for patients transitioning to home care are required to file the CA Magellan Healthcare Bridge to Home Coordination Form.
To fill out the CA Magellan Healthcare Bridge to Home Coordination Form, the provider should gather all relevant patient information, including medical history, current medications, and home care needs, and complete each section of the form clearly and accurately before submitting it.
The purpose of the CA Magellan Healthcare Bridge to Home Coordination Form is to ensure continuity of care for patients by providing essential information to home care providers, thereby improving patient outcomes during the transition from hospital to home.
The information that must be reported on the CA Magellan Healthcare Bridge to Home Coordination Form includes patient demographics, discharge diagnoses, medications, follow-up care requirements, and any special instructions or considerations for home healthcare providers.
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