Get the free CHDP Care Coordination Follow-up Form - Health Net

Child Health and Disability Prevention Program Care Coordination / Followup Resubmit to the County CHIP Program within 5 business days of the examination fax: (XXX) XXXIX Do not complete this form

How to fill out chdp care coordination follow-up

How to fill out chdp care coordination follow-up

1. To fill out the CHDP care coordination follow-up form, follow these steps:
2. Start by entering the child's information, including their name, date of birth, and CHDP ID number (if available).
3. Next, provide details about the child's medical history, including any previous CHDP exams, immunizations, and developmental assessments.
4. Document any current medical concerns or conditions that require follow-up care.
5. Indicate any referrals that have been made for specialist care or additional services.
6. Note any barriers or challenges in obtaining the recommended follow-up care.
7. Include information about the child's primary care provider and any other healthcare professionals involved in their care.
8. Finally, sign and date the form to certify the information provided.
9. Remember to review and verify all information before submitting the form.

Who needs chdp care coordination follow-up?

1. CHDP care coordination follow-up is needed for children who have undergone a CHDP exam and require additional care or follow-up services.
2. This includes children who have been identified with medical concerns, developmental delays, or who require referrals to specialist care or other support services.
3. The follow-up helps ensure that these children receive the necessary care and support to address their health and developmental needs.

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What is chdp care coordination follow-up?

CHDP care coordination follow-up is a process of ensuring that scheduled services are provided to children enrolled in the Child Health and Disability Prevention (CHDP) program.

Who is required to file chdp care coordination follow-up?

Health care providers and clinics participating in the CHDP program are required to file care coordination follow-up reports.

How to fill out chdp care coordination follow-up?

CHDP care coordination follow-up reports can be filled out electronically or using paper forms provided by the program.

What is the purpose of chdp care coordination follow-up?

The purpose of CHDP care coordination follow-up is to ensure that enrolled children receive necessary preventive health care services.

What information must be reported on chdp care coordination follow-up?

Information such as patient demographics, services provided, and follow-up recommendations must be reported on CHDP care coordination follow-up forms.