Get Post-acute Transitions Of Care Authorization Form. Post-acute Transitions Of Care Authorization Form

The Post-Acute Transitions of Care Authorization Form is designed to facilitate the authorization process for post-acute services. This guide will provide you with clear, step-by-step instructions on how to fill out the form accurately and efficiently.

Follow the steps to complete the authorization form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the 'Member Name' field with the full name of the individual requiring services.
3. Next, enter the 'CareFirst ID number' associated with the member. This is a crucial identifier for processing the request.
4. In the 'Current Location of the member' section, provide the current address or location where the member is receiving care.
5. Specify the 'Requested Level of Care', detailing the type of care being requested.
6. Fill in the 'Receiving Facility' field with the name of the facility that will provide the post-acute care.
7. Indicate the 'Date of Admission to Receiving Facility', providing the expected or actual admission date.
8. Provide the 'Primary Diagnosis' for the member, ensuring accuracy to assist in care planning.
9. List the 'Attending Physician', including their contact details if applicable.
10. Complete the 'Contact information for Receiving Facility' by entering the name and phone number of the primary contact.
11. Fill out the 'Address of Receiving Facility' with complete details including street address, city, state, and zip code.
12. Once all fields are filled, you can save the changes, download a copy, print the form, or share it as needed.

Complete your Post-Acute Transitions of Care Authorization Form online today.