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Higher Level of Care Registration/Concurrent Review Template All fields with * are required. *Requested Start Date for this Request: *Has the member already been admitted to the facility? *Type of
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How to fill out higher level of care

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Contact your healthcare provider to discuss your current symptoms and needs
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Work with your provider to determine if a higher level of care is necessary
03
Complete any required forms or assessments for the higher level of care
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Follow the instructions provided by your healthcare provider for next steps

Who needs higher level of care?

01
Individuals with complex medical conditions that require specialized care
02
Individuals with severe mental health issues that cannot be managed in a lower level of care
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Individuals who are a danger to themselves or others and require constant supervision
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Higher level of care refers to the level of care provided to individuals who require more intensive medical attention and support than standard care.
Healthcare providers or facilities that provide higher level of care are required to file the appropriate documentation.
Higher level of care can be filled out by documenting the medical needs and interventions provided to the individual requiring this level of care.
The purpose of higher level of care is to ensure that individuals with complex medical needs receive the necessary support and treatment.
Information such as the individual's medical history, current medical needs, treatment plan, and any specialized care provided must be reported on higher level of care forms.
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