Last Covered Date: 2026

The 'Bridge to Home Coordination Form' is a document used by Magellan Healthcare to facilitate the discharge process for members transitioning from healthcare facilities. It requires completion of five sections, including member information, follow-up appointment details, clinical status and discharge medications, and encounter service information. The form emphasizes the importance of scheduling timely follow-up appointments and ensuring proper medication management and patient education before discharge.

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Click ‘Get Form’ to open the Bridge to Home Coordination Form in the editor.
Locate the 'Last Covered Date:' field. This is where you will input the date that reflects the last time coverage was provided for the member.
Ensure that you enter the date in the correct format, typically MM/DD/YYYY, to avoid any processing issues.
Review all other sections of the form to ensure completeness, as all five sections must be filled out before submission.
Once completed, save your changes and follow the instructions for faxing the form to either WHA or BSC as indicated at the bottom of the document.

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