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CONTINUITY OF CARE Cagney Healthcare of California593690 d L CA 12/22Your CignaHealthCare of California Continuity of Care benefits Continuity of Care benefits are intended to provide coverage for

How to fill out um-41-continuity-of-care-when-a-provider-terminates

How to fill out um-41-continuity-of-care-when-a-provider-terminates

1. Step 1: Obtain a copy of the UM-41 Continuity of Care form from your healthcare provider or insurance company.
2. Step 2: Fill out the patient information section, including your name, date of birth, and contact information.
3. Step 3: Provide details about the terminating provider, such as their name, specialty, and the reason for termination.
4. Step 4: Indicate the date on which the provider will no longer be available to provide care.
5. Step 5: Specify the ongoing medical conditions or treatments that require continuity of care.
6. Step 6: Provide information about any alternative healthcare providers you have found or would like to be considered for the continuation of your care.
7. Step 7: Sign and date the form to confirm that the information provided is accurate and complete.
8. Step 8: Submit the completed UM-41 Continuity of Care form to your healthcare provider or insurance company as instructed.

Who needs um-41-continuity-of-care-when-a-provider-terminates?

1. Patients who currently receive care from a provider who intends to terminate their services.
2. Patients with ongoing medical conditions or treatments that require uninterrupted care.
3. Patients who want to ensure a smooth transition to a new healthcare provider.

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What is um-41-continuity-of-care-when-a-provider-terminates?

UM-41 Continuity of Care When a Provider Terminates is a form that outlines the steps to ensure ongoing care for patients when a healthcare provider terminates their services.

Who is required to file um-41-continuity-of-care-when-a-provider-terminates?

Healthcare facilities and providers are required to file UM-41 Continuity of Care When a Provider Terminates.

How to fill out um-41-continuity-of-care-when-a-provider-terminates?

UM-41 Continuity of Care When a Provider Terminates can be filled out by providing details about the transitioning of patient care to a new provider or facility.

What is the purpose of um-41-continuity-of-care-when-a-provider-terminates?

The purpose of UM-41 Continuity of Care When a Provider Terminates is to ensure that patients continue to receive necessary care without interruption.

What information must be reported on um-41-continuity-of-care-when-a-provider-terminates?

UM-41 Continuity of Care When a Provider Terminates requires information about the patients affected, the terminating provider, and the arrangements for ongoing care.