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Care Coordination Referral and Consent Form Referral Information Referral date:___Referring Service:___Referring Worker:___Contact (email):___Contact (phone):___Care Coordination Group Referred to:
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01
Gather all necessary information related to the patient's medical history, current condition, and any specific needs or concerns.
02
Complete the referral form with accurate and detailed information about the patient, including their contact information, insurance details, and the reason for the referral.
03
Submit the completed referral form to the appropriate care coordination team or department, either electronically or by mail.
04
Follow up with the care coordination team to ensure that the referral has been received and processed, and to provide any additional information or clarification if needed.

Who needs care coordination referral and?

01
Patients with complex medical conditions that require coordination between multiple healthcare providers.
02
Patients who may benefit from additional support or resources to navigate the healthcare system and access necessary services.
03
Patients who have been recently discharged from the hospital or are transitioning between different levels of care.
04
Patients with chronic illnesses or disabilities that require ongoing management and support.
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Care coordination referral is a process in which healthcare providers communicate and collaborate to ensure patients receive comprehensive and seamless care.
Healthcare providers, including physicians, nurses, and other professionals involved in a patient's care, are required to file care coordination referrals.
Care coordination referrals can be filled out electronically or via paper forms, typically including patient information, medical history, and details of necessary care.
The purpose of care coordination referral is to facilitate communication among healthcare providers, streamline patient care, and improve health outcomes.
Key information to be reported on care coordination referrals includes patient's demographic data, medical history, current health status, and care plan.
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