Get the free Continuity of Care Request Form

The Continuity of Care Department for Health Net assists recipients in receiving managed care without a gap in coverage. To request the continuity of care benefit, patients must complete a request

How to fill out continuity of care request

How to fill out continuity of care request

1. Identify the reason for the continuity of care request.
2. Gather relevant medical records and documentation from previous providers.
3. Fill out the continuity of care request form with patient information, including name, date of birth, and insurance details.
4. Specify the health condition or treatment plan that requires continuity of care.
5. List any previous healthcare providers involved in the patient's care.
6. Submit the completed request form along with the gathered medical documents to the new provider or insurance company.
7. Follow up with the new provider or insurance for confirmation and any additional requirements.

Who needs continuity of care request?

1. Patients transitioning from one healthcare provider to another.
2. Individuals requiring ongoing treatment for chronic conditions.
3. Patients who are switching health insurance plans.
4. Those needing specialized services from a new provider.
5. Individuals who want to maintain a consistent treatment plan while changing doctors.

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What is continuity of care request?

A continuity of care request is a formal request made by a patient to ensure that they can continue receiving care from a specific healthcare provider when there is a change in their insurance plan or provider network.

Who is required to file continuity of care request?

Typically, the patient or their authorized representative is required to file a continuity of care request, especially if they wish to continue treatment with a provider who is no longer in their insurance network.

How to fill out continuity of care request?

To fill out a continuity of care request, a patient must provide personal information, details about their current healthcare provider, information about the medical condition or treatment, and any relevant insurance information. It's often done through a specific form provided by the insurance company.

What is the purpose of continuity of care request?

The purpose of a continuity of care request is to facilitate the ongoing treatment of a patient by allowing them to maintain access to their current healthcare provider, ensuring there are no interruptions in care due to changes in their insurance coverage.

What information must be reported on continuity of care request?

The information that must be reported on a continuity of care request typically includes the patient's name, contact information, details of the treatment or condition, the name and address of the healthcare provider, and the specific insurance details.