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How to fill out the Dhec Best Chance Network online
Filling out the Dhec Best Chance Network form is an essential step for facilitating case management services. This guide provides clear instructions to help you complete the online form accurately and efficiently.
Follow the steps to complete the form successfully.
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Start by filling out the identifying data in the first section, including the last name, first name, address, city, state, zip code, and other personal information of the client being referred.
- In the next section, indicate the referral source by filling out 'BCN' and the referring facility's name, along with the full details of the person making the referral, including their phone number.
- Complete the patient's details, such as doctor's name, date of birth (DOB), race, and marital status, ensuring all fields are accurately filled in.
- Fill in emergency contact information, including the name, relationship to the client, and home and work phone numbers.
- In the test results section, circle the applicable diagnosis numbers, enter the date the test was completed, and provide any relevant comments regarding the referral.
- For follow-up referrals, write the name and phone number of the follow-up facility, as well as the purpose of the referral and the date of the appointment.
- If known, include the Medicaid coverage effective date and indicate whether you would like the social worker to contact you before seeing the client by marking 'Yes' or 'No'.
- Ensure that the BCN staff member processing the referral signs the form and includes the date when the referral was received.
- After reviewing all the information for accuracy, users can then save the changes, download, print, or share the completed form as needed.
Start completing the Dhec Best Chance Network form online today for efficient case management support.
The safe home program in South Carolina is a critical initiative that provides temporary assistance and resources for families and individuals in need of safe housing. This program offers shelter, referrals, and support services, playing a vital role in protecting vulnerable populations. By working within the framework established by the Dhec Best Chance Network, the safe home program aims to ensure families have access to secure living conditions.
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