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Mercy Care RSHA Bridge to Permanency Application NO: Direct Care Clinic: Case manager (print name): Case manager email: Case manager phone: Indicate Housing Authority (select only one):Maricopa County

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How to fill out mercy care rbha bridge

01

Gather all necessary information such as personal details and medical history.

02

Download or obtain a copy of the Mercy Care RBHA Bridge form.

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Fill out the form accurately, providing all required information.

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Double-check the completed form for any errors or missing information.

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Submit the filled-out form to the appropriate Mercy Care RBHA office or mailing address.

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Wait for confirmation or follow-up from Mercy Care RBHA regarding your bridge application.

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Follow any additional instructions or steps provided by Mercy Care RBHA if necessary.

Who needs mercy care rbha bridge?

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Individuals who are currently enrolled in Mercy Care RBHA and are in need of continuous care during transitions, such as transitioning between healthcare providers or moving to a new location, may need the Mercy Care RBHA Bridge. It is designed to ensure uninterrupted access to necessary healthcare services during these transitions.

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What is mercy care rbha bridge?

Mercy Care RBHA Bridge is a form used to request for services through Mercy Care for individuals with behavioral health needs.

Who is required to file mercy care rbha bridge?

Providers, case managers, or family members may be required to file Mercy Care RBHA Bridge on behalf of the individual in need of services.

How to fill out mercy care rbha bridge?

To fill out Mercy Care RBHA Bridge, you will need to provide information about the individual in need of services, their behavioral health needs, and the requested services.

What is the purpose of mercy care rbha bridge?

The purpose of Mercy Care RBHA Bridge is to facilitate access to behavioral health services for individuals in need.

What information must be reported on mercy care rbha bridge?

Information that must be reported on Mercy Care RBHA Bridge includes the individual's demographic information, behavioral health needs, requested services, and any other relevant details.

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