[DATE]

Dear Dr XXX

[Member Name] [Member DOB] is a member of HealthPartners Inspire. a Special Needs BasicCare (SNBC) plan to provide health care for people with disabilities.

As your patient’s Care Coordinator, I recently met with your patient at his/her home to complete a comprehensive health risk assessment.

Enclosed is a copy of the care plan developed with your patient based on the results of the assessment.

[Insert specific visit-related content]

I will periodically communicate with you by phone if there are any concerns or needs that I become aware of while case managing your patient.

Please inform me of any specific issues or concerns that I can help address. I can be contacted at [XXXXXXXX].

My goal is to work with you and your team to keep your patient independent and in the community, while preventing unnecessary hospitalizations or nursing home placements. My role includes:

Partnering with the patients interdisciplinary care team and facilitating collaboration as needed

Working to optimize the patients’ health and well-being and self-management of their chronic conditions.

Alerting you to concerns and issues about how your patient is functioning at home, giving particular attention to compliance and safety.

Arranging community resources, home-care services, and equipment.

Being a point person during all transitions of care; screening for red flags and encouraging prompt follow up appointments

Encouragement and monitoring of preventive care, relevant medical tests, and mental health concerns.

Sincerely,

[Care Coordinator Name]

SNBC Care Coordinator, HealthPartners Inspire

Phone:

Toll-Free:

Enclosure: Care Plan