Continuation request form 2026

Get Form
continuation request form Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out continuation request form with DocHub

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the continuation request form in our editor.
  2. Begin by entering the date at the top of the form. This helps track when the request is submitted.
  3. Fill in your personal information under 'Form completed by', including your name and phone number for contact purposes.
  4. In the 'REASON FOR REQUEST' section, select the appropriate reason for your request, ensuring it aligns with AmeriHealth NJ's guidelines.
  5. Complete the 'MEMBER INFORMATION' section with details such as Member ID, effective date of coverage, previous insurance carrier, and patient information.
  6. Provide 'DOCTOR INFORMATION' by filling in your doctor's name, NPI or TIN, and contact details.
  7. Detail the diagnosis and treatment plan by including relevant CPT codes and expected duration of treatment.
  8. Finally, ensure you attach any necessary clinical documentation before submitting your form through our platform.

Start using our platform today to streamline your continuation request process for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
Paid 5-7 days after certification and submission to the servicing finance office from the unit S-1; the remainder in three equal annual installments. When Do I Need to Make My CP Election? See Army Calendar Year Guidance at: . FinancialFrontline.org/ soldier/continuation-pay/.
Members receive Continuation Pay in return for additional obligated service. Active component service members (including Active Guard Reserve (AGR) and Full Time Support (FTS)) enrolled in the BRS will be eligible for a cash incentive of 2.5 to 13 times their regular monthly basic pay.
You must be enrolled in the BRS, agree to perform additional obligated service, and elect to receive CP before you start your 12th year of service (ing to your Pay Entry Base Date).
No, continuation pay is a one-time payout to a service member, regardless of whether they change service, component, or career specialty. Q7. Can the service obligation for continuation pay and other bonuses, such as a reenlistment bonus, be served concurrently? A7.
All Soldiers may submit their Continuation Pay request through the BRS-CP Request Form once they become eligible. Contact your unit S1 and your State Incentive Manager to initiate the process.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more
ccpa2
pci-dss
gdpr-compliance
hipaa
soc-compliance