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Higher Level of Care AUTHORIZATION FAX REQUEST FORM PreService Fax: 213.438.5761 Phone: 877.431.2273 COMPLEX CANCER COMPLEX CARDIAC COMPLEX RESPIRATORYInpatient Fax: Phone: COMPLEX GUN COMPLEX GASTROINTESTINAL
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How to fill out higher level of care

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How to fill out higher level of care

01
Begin by discussing the higher level of care recommendation with the individual's primary healthcare provider.
02
Obtain a referral for higher level of care from the primary healthcare provider.
03
Research and identify appropriate higher level of care facilities or centers.
04
Contact the chosen facility to inquire about their admission process and any required documentation.
05
Complete all necessary paperwork, including medical history forms, insurance information, and consent forms.
06
Schedule a comprehensive assessment with the chosen facility to determine eligibility for higher level of care.
07
Prepare all required documentation and medical records to submit during the assessment process.
08
Attend the assessment appointment and provide honest and accurate information about the individual's condition and needs.
09
Wait for the assessment results and recommendations from the higher level of care facility.
10
Follow the facility's instructions for admission, including scheduling an intake appointment and arranging transportation.
11
Ensure all necessary supportive services and resources, such as transportation and care coordination, are in place for the individual's transition to higher level of care.
12
Communicate with the primary healthcare provider and other involved professionals to coordinate and facilitate the transition process.
13
Support the individual in adjusting to the higher level of care environment and help them understand the expectations and available support services.

Who needs higher level of care?

01
Individuals who require a higher level of care typically have complex or severe medical conditions that cannot be adequately managed at a lower level of care.
02
They may have debilitating physical or mental health conditions that require specialized medical attention and monitoring.
03
Higher level of care may be necessary for individuals who have recently undergone surgery or experienced a serious illness or injury that requires extensive rehabilitation and medical supervision.
04
People with chronic conditions that require ongoing medical intervention and support, such as cancer, organ failure, or advanced stage illnesses, may also need higher level of care.
05
Additionally, individuals with significant functional impairments or disabilities that affect their daily living activities and require assistance with tasks like bathing, dressing, or mobility are likely to benefit from higher level of care.
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Higher level of care refers to specialized medical attention that goes beyond standard treatment, typically provided in more advanced healthcare settings such as hospitals or specialized facilities.
Healthcare providers, particularly those offering services that necessitate a greater degree of medical supervision and support, are required to file for higher level of care.
To fill out higher level of care, providers must complete the designated form detailing the patient's medical condition, required services, and justification for the higher level of care.
The purpose of higher level of care is to ensure that patients receive appropriate, timely, and specialized medical treatment necessary for their specific health needs.
Information that must be reported includes patient demographics, medical history, the nature of the medical condition, required services, and clinician's recommendations.
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