Get the free Orthodontic Continuation of Care Submission Form - UnitedHealthcare Community Plan o...

Orthodontic Continuation of Care Submission Form Date:Patient information Name (first & last):Date of birth:Address:City, State, ZIP:Area code and phone number:Plan name:Medicaid ID#:Provider information

How to fill out orthodontic continuation of care

How to fill out orthodontic continuation of care

1. Obtain the patient's current orthodontic records, including treatment progress and any pertinent notes.
2. Fill out the basic patient information, including name, contact details, and insurance information.
3. Document the reason for continuing care, such as ongoing treatment or specific orthodontic issues.
4. List any specific orthodontic procedures that have been performed or are planned.
5. Include details about the patient's oral health and any recommendations for future treatment.
6. Ensure all sections are completed clearly and accurately before submitting.

Who needs orthodontic continuation of care?

1. Patients who are currently undergoing orthodontic treatment and require ongoing care.
2. Individuals who have completed initial orthodontic treatment but require follow-up care.
3. Patients with specific orthodontic concerns that necessitate continued monitoring and treatment.
4. Those transitioning from one orthodontist to another, ensuring care continuity.

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What is orthodontic continuation of care?

Orthodontic continuation of care is the ongoing treatment and monitoring provided to patients who have undergone orthodontic procedures, ensuring that their teeth and jaws remain in the desired position.

Who is required to file orthodontic continuation of care?

Orthodontists are typically required to file orthodontic continuation of care on behalf of their patients to document ongoing treatment progress.

How to fill out orthodontic continuation of care?

To fill out orthodontic continuation of care, orthodontists should provide patient information, details of the treatment plan, ongoing progress notes, and any adjustments made during the treatment period.

What is the purpose of orthodontic continuation of care?

The purpose of orthodontic continuation of care is to ensure proper healing and alignment of teeth and jaws, to monitor patient progress, and to make necessary adjustments or interventions as needed.

What information must be reported on orthodontic continuation of care?

The information that must be reported includes patient identification, treatment details, progress notes, any corrections or adjustments made, and future treatment plans.