Get the free CONTINUITY OF CARE REQUEST: DATE: - Daytona State College

AUTHORIZATION TO RELEASE PROTECTED HEALTH INFORMATION (PHI) FLORIDA HEALTH CARE PLANS P.O. BOX 9910 DAYTONA BEACH, FL 32120 PLEASE FAX MEDICAL RECORDS TO: 3864815009 OR 8884274544FHCP Medical Record

How to fill out continuity of care request

How to fill out continuity of care request

1. To fill out a continuity of care request, follow these steps:
2. Obtain the continuity of care request form from your healthcare provider or insurance company.
3. Fill in your personal information, including your name, contact details, and insurance information.
4. Provide relevant details about your current healthcare provider, including their name, address, and contact information.
5. Indicate the specific medical condition or treatment for which you are requesting continuity of care.
6. Explain why it is necessary for you to continue receiving care from your current provider, emphasizing any unique circumstances or complexities in your medical history.
7. Attach supporting documents or medical records that validate your need for continuity of care.
8. Review the completed form for accuracy and completeness.
9. Submit the continuity of care request to your healthcare provider or insurance company, following their specified submission process.
10. Keep a copy of the request form and any related communication for your records.
11. Follow up with your provider or insurance company to ensure that your continuity of care request has been processed and approved.

Who needs continuity of care request?

1. Any individual who is currently receiving ongoing medical treatment from a specific healthcare provider and wishes to continue receiving care from the same provider may need to submit a continuity of care request.
2. This request is commonly required when an individual switches insurance plans, changes healthcare providers, or experiences a change in their insurance coverage that could potentially disrupt their continuity of care.
3. It is particularly important for individuals with complex medical conditions or those who require specialized treatments to ensure that their continuity of care is maintained.

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What is continuity of care request?

Continuity of care request is a formal process that allows a patient to continue treatment with a specific healthcare provider even if there are changes to their insurance coverage or network.

Who is required to file continuity of care request?

Patients who are in the middle of a treatment plan with a provider that is no longer in-network with their insurance company are required to file a continuity of care request.

How to fill out continuity of care request?

To fill out a continuity of care request, patients typically need to contact their insurance company and fill out a form that includes information about their current treatment plan and provider.

What is the purpose of continuity of care request?

The purpose of continuity of care request is to ensure that patients can continue receiving treatment from a specific provider without interruption, even if there are changes to their insurance coverage.

What information must be reported on continuity of care request?

The information reported on a continuity of care request typically includes details about the patient's current treatment plan, the provider they are seeing, and why continuity of care is necessary.