Pola oznaczone znakiem * są wymagane

Referral to Care Coordination

The Care Coordination Program helps CountyCare members with medical, behavioral health, and support services to improve their health care. Care Coordinators help members use their benefits to get needed services and find their way through the health care system. Members with specific health needs may also enroll in Care Management and/or Disease Management Programs.

Clinicians, Discharge Planners, Utilization Reviewers and Caregivers: Please use this form to refer members to these programs. Within five (5) business days of receiving this referral, a Care Coordinator will reply to the contact people listed on this form. If the need is more urgent, please call 312-864-8200, 711 (TDD/TTY) and press option 4, then option 8.

Members: If you want to refer yourself to Care Coordination, you can bypass this form by sending an email message through the Member Portal at https://countycare.com/members/portal


*

*
*
*
Polski
262728293031123456789101112131415161718192021222324252627282930123456
262728293031123456789101112131415161718192021222324252627282930123456