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Get the free Long Term Acute Care (LTAC) Precertification Worksheet

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LONG TERM ACUTE CARE PREADMISSION EVALUATIONAn Independent Licensee of the Blue Cross and Blue Shield AssociationPlease fax this form to the Patients Care Coordinator at BLUE CROSS AND BLUE SHIELD
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01
Gather the necessary patient information, including personal details and medical history.
02
Complete the initial assessment forms with details of the patient's current medical condition.
03
Fill out relevant documentation regarding the patient's daily care needs and rehabilitation goals.
04
Provide information on previous treatments and any ongoing therapies that the patient requires.
05
Ensure that all sections related to insurance, consent, and funding are filled out accurately.
06
Review the completed forms for any missing information or errors before submission.
07
Submit the application to the designated long term acute care facility.

Who needs long term acute care?

01
Patients with complex medical conditions that require extended hospitalization and specialized care.
02
Individuals recovering from severe illnesses, surgeries, or trauma who need additional support beyond standard recovery.
03
Patients requiring ongoing respiratory support, wound care, or rehabilitation therapies.
04
Those who have chronic conditions that necessitate continuous medical attention and nursing support.
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Long term acute care (LTAC) refers to a specialized type of hospital or healthcare facility that provides extended medical care for patients with serious, complex medical conditions that require a longer length of stay, typically more than 25 days.
Healthcare providers, such as LTAC hospitals and facilities, are required to file long term acute care claims when treating patients who meet specific criteria for extended acute care services.
To fill out long term acute care documentation, providers must gather patient information, medical history, treatment plans, and billing codes, and then complete the necessary forms accurately according to the healthcare regulations and guidelines.
The purpose of long term acute care is to provide comprehensive and specialized treatment to patients with severe illnesses or injuries that require ongoing medical support and rehabilitation, enabling them to recover or transition to a lower level of care.
Information that must be reported includes patient demographics, diagnosis codes, treatment details, length of stay, service dates, and any relevant medical history or comorbid conditions.
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