Get the free Continuity of Care Form - Blue Cross NC

Continuity of Care Form Continuity of care will be issued under special circumstances to allow members to continue treatment with a nonplan provider(s) for a period of time following the date of enrollment.

How to fill out continuity of care form

How to fill out continuity of care form

1. To fill out the continuity of care form, follow these steps:
2. Obtain the continuity of care form from your healthcare provider or download it from their website.
3. Read the instructions on the form carefully to understand the required information.
4. Fill in your personal details such as your name, date of birth, and contact information.
5. Provide details about your current healthcare provider, including their name, address, and contact information.
6. Specify the date range for which you require continuity of care.
7. Indicate the reason for needing continuity of care, such as a planned move or transition between healthcare providers.
8. Mention any specific conditions or medical history that is relevant to your continuity of care needs.
9. Sign and date the form to confirm the accuracy of the provided information.
10. Submit the completed form to your new healthcare provider or the appropriate recipient as instructed.
11. Retain a copy of the form for your records and keep it handy for future reference.

Who needs continuity of care form?

1. The continuity of care form is typically required by individuals who:
2. - Are switching healthcare providers
3. - Are moving to a new location and need their medical records transferred
4. - Have complex medical conditions that necessitate ongoing and coordinated care
5. - Are transitioning from one healthcare setting to another, such as from a hospital to a nursing home or home care
6. - Are seeking specialized services from a different healthcare provider
7. - Require ongoing medical treatment or medication management

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What is continuity of care form?

The continuity of care form is a document that allows healthcare providers to ensure the coordinated and uninterrupted care for patients during transitions between different healthcare settings.

Who is required to file continuity of care form?

Healthcare providers and organizations involved in the care of patients are required to file the continuity of care form.

How to fill out continuity of care form?

The continuity of care form can be filled out by providing relevant patient information, current medications, treatment plans, and any other important details related to the patient's care.

What is the purpose of continuity of care form?

The purpose of the continuity of care form is to maintain the continuity of care for patients, ensuring that all healthcare providers involved in the patient's care have access to necessary information.

What information must be reported on continuity of care form?

The continuity of care form must include patient demographics, medical history, current medications, treatment plans, and any other relevant information that can aid in the coordination of care.