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Click ‘Get Form’ to open the case management PCCM form in the editor.
Begin by filling out the Primary Care Provider Information section. Enter the provider's name, contact name, telephone number, NPI, and TPI.
Next, complete the Client Information section. Input the client's name, Medicaid number, date of birth, referral date, and telephone number.
If applicable, provide details in the Referring Provider Information section. Include their name, contact name, telephone number, NPI, and TPI.
In the Consulting Provider/Facility section, enter the provider/facility name, telephone number, address, appointment time and date. If known, include the Medicaid number.
Specify the reason for referral and select from options such as evaluation only or evaluation and treatment. Ensure to detail any other specifications if necessary.
Finally, add any consultant comments and ensure both consultant signature and date are filled out before submitting.
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What is the difference between case management and targeted case management?
Focus: Care managers primarily focus on managing medical care and treatment, while case managers focus on coordinating services and resources for clients with complex needs.
What is a PCCM?
General case management may focus on just one or two service areas. Duration: Targeted case management provides long-term support and monitoring, sometimes for years, depending on the client. General case management typically involves short-term connections.
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Person-Centered Case Management (PCCM) Certificate
The six-course Person-Centered Case Management (PCCM) certificate, with 24 CEs, is an alternative to our five-course Case Management Certificate, with 20 CEs.
SoonerCare Choice is a Primary Care Case Management (PCCM) program in which each member has a medical home. The medical home provider will coordinate all
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