Follow the steps to effectively complete the Healthy Blue BSCPEC-1270-19 form.

1. Press the ‘Get Form’ button to acquire the Healthy Blue BSCPEC-1270-19 form and open it in your editing interface.
2. Begin by filling out the member information. Include the following fields: Member name, Member ID, Member Medicaid ID, Member date of birth, and Member phone number. Ensure all details are accurate and up-to-date.
3. Add the facility information by providing the Facility name and discharge date. This section helps identify the member's treatment background.
4. Complete the facility contact details. Fill in the Facility contact name, Facility phone number, and Facility fax number to facilitate communication.
5. For the section designated for South Carolina Department of Mental Health/Community Mental Health staff, enter the Date of appointment post-discharge and the Provider's name along with their Phone number.
6. Indicate whether the member kept the scheduled appointment by circling Yes or No. If the appointment was not kept, provide the date when the appointment was rescheduled.
7. Ensure all required fields are completed. Review the form for accuracy and clarity, then proceed to fax this form to the designated number at 877-664-1499.
8. Finalize your document management by saving any changes you have made, and consider downloading, printing, or sharing the form as necessary.

Complete your Healthy Blue BSCPEC-1270-19 form online today to ensure timely processing and support.