Get the free Continuation of Care Request Form AmeriHealth New Jersey ...

Please Mail To: AmeriHealth New Jersey, Attn: Continuation of Care 259 Prospect Plains Road, Bldg M Bradbury, NJ 08512 FAX: (609) 6622559Continuation of Care Request Form AmeriHealth New Jersey Clinical

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. Obtain the continuation of care request form from your healthcare provider. This form may also be available on their website.
3. Fill out your personal information such as your name, address, date of birth, and contact information.
4. Provide details about your current healthcare provider, including their name, address, and contact information.
5. Specify the reason for the continuation of care request. Explain why you need to continue receiving care from your current healthcare provider.
6. Attach any supporting documents or medical records that may be relevant to your request.
7. Review the completed form for accuracy and make sure all required fields are filled out.
8. Submit the continuation of care request form to your healthcare provider through their preferred method, such as in person, by mail, or through an online portal.
9. Follow up with your healthcare provider to ensure they have received and processed your request. You may need to provide additional information or documentation if requested.
10. Keep a copy of the completed form and any supporting documents for your records.
11. Wait for a response from your healthcare provider regarding the approval or denial of your continuation of care request. Follow any further instructions or recommendations provided.

Who needs continuation of care request?

1. A continuation of care request is needed by individuals who want to continue receiving healthcare services from their current healthcare provider even when there are changes in their insurance coverage, healthcare plans, or the provider's network.
2. This request is commonly made when there is a transition such as changing jobs, switching insurance plans, relocating to a new area, or when a healthcare provider is no longer part of the individual's insurance network.
3. It allows individuals to maintain continuity of care and ensures they can continue receiving treatment, medications, or services from their trusted healthcare provider.

For pdfFiller’s FAQs

What is continuation of care request?

Continuation of care request is a request made by a patient to ensure that their medical care continues seamlessly even when transitioning to a new provider or caregiver.

Who is required to file continuation of care request?

Patients who are transitioning to a new provider or caregiver are required to file a continuation of care request.

How to fill out continuation of care request?

Continuation of care request can be filled out by providing patient information, previous medical history, current medications, and any specific instructions for the new provider.

What is the purpose of continuation of care request?

The purpose of continuation of care request is to ensure that there is a smooth transition of medical care for the patient without any interruptions.

What information must be reported on continuation of care request?

Information such as patient details, medical history, current medications, allergies, and any specific instructions for the new provider must be reported on a continuation of care request.

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