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Managed Long Term Services and Supports (ML TSS) Referral Form Phone: 855.427.1223 Fax: 213.438.4866 Email: mltss@lacare.org (send via secured email only) Referral Source: ___ Date of Referral: ___
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How to fill out managed long term services
How to fill out managed long term services
01
Contact your managed long term care plan to inquire about the specific requirements and procedures for filling out the necessary paperwork.
02
Gather all relevant information including your medical history, current medications, and any relevant documentation from healthcare providers.
03
Fill out the forms accurately and completely, ensuring to include all requested information.
04
Submit the completed paperwork to your managed long term care plan for review and approval.
Who needs managed long term services?
01
Individuals who require ongoing medical and personal care due to chronic illnesses or disabilities.
02
Senior citizens who need assistance with daily activities such as bathing, grooming, and meal preparation.
03
Those who have complex medical needs that require coordinated and comprehensive care over an extended period of time.
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What is managed long term services?
Managed long term services refer to a range of programs and supports designed to help individuals with chronic illnesses, disabilities, or other conditions to live independently in the community.
Who is required to file managed long term services?
Individuals who are receiving or applying for long term services and supports are required to file managed long term services.
How to fill out managed long term services?
Managed long term services can be filled out by providing information about the individual's needs, preferences, and goals for living independently.
What is the purpose of managed long term services?
The purpose of managed long term services is to help individuals maintain their independence and quality of life while receiving the necessary supports and services.
What information must be reported on managed long term services?
Managed long term services typically require information about the individual's medical history, functional abilities, and support network.
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