Get Nursing Facility (nf) Communication Form

Navigating the Nursing Facility Communication Form (DHS-4461) online can be straightforward with the right guidance. This form is essential for ensuring proper communication between nursing facilities and health plans regarding member information and claims.

Follow the steps to successfully fill out the Nursing Facility Communication Form

1. Press the 'Get Form' button to obtain the Nursing Facility Communication Form and access it in your preferred online tool.
2. Begin by filling out the member information section, including the member's name, date of birth, health plan ID, PMI, admit diagnosis code, admission source, and discharge destination.
3. Proceed to the facility information segment. Here, input the nursing facility's name, provider NPI, address, contact name, phone number, fax number, and email address.
4. Complete the member tracking information section, indicating the relevant codes and rates, along with the number of days covered by the health plan.
5. For changes in resident status or reasons for bed holds, select the appropriate reason codes from the provided list.
6. Ensure that all information is accurate and complete, as this will assist in the processing and communication with the health plan.
7. Once all sections are filled out, review the form for any errors or missing information before proceeding to finalize.
8. Save your changes and share or print the form as needed for submission to the health plan.

Start completing your forms online to ensure timely communication and processing.