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Enhanced Care Management (ECM) Member Referral FormEnhanced Care Management Member Referral Form For referrals to Enhanced Care Management (ECM) Services, fill out this referral form and have your
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How to fill out enhanced care management program

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How to fill out enhanced care management program

01
Attend the orientation session for the enhanced care management program to understand the program requirements and expectations.
02
Complete the intake form with your personal information, medical history, and current medications.
03
Schedule an initial assessment with a care manager to discuss your health goals and create a care plan.
04
Attend regular check-in appointments with your care manager to monitor your progress and make any necessary adjustments to your care plan.
05
Participate in any recommended health education classes or support groups to learn more about managing your health conditions.
06
Keep track of your appointments, medications, and symptoms to share with your care manager during check-ins.
07
Communicate openly with your care manager about any concerns, challenges, or questions you have about your health care.

Who needs enhanced care management program?

01
Individuals with chronic health conditions such as diabetes, heart disease, or asthma that require ongoing management and support.
02
Patients who have recently been discharged from the hospital and need additional follow-up care to prevent readmission.
03
Seniors who require assistance with coordinating their medical care and managing multiple health conditions.
04
Patients with complex medical needs who would benefit from a personalized care plan and regular monitoring by a care manager.
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Enhanced care management program is a program designed to improve the quality and coordination of care for individuals with complex healthcare needs.
Healthcare providers and organizations responsible for managing the care of individuals with complex healthcare needs are required to file enhanced care management program.
Enhanced care management program can be filled out by providing detailed information about the individual's medical history, current health status, treatment plans, and healthcare providers involved in their care.
The purpose of enhanced care management program is to ensure that individuals with complex healthcare needs receive the appropriate level of care and support to improve their health outcomes.
Information such as medical history, current health status, treatment plans, medications, healthcare providers, and care coordination activities must be reported on enhanced care management program.
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