CSAT full form :
Publication Number CSAT Form (Standard Format) General Information Full Name Full Address Address Line 1
Summary of Medical Care Utilization & Assessment Utilization
Information on Current Medical Status,
Old Diagnosis Type & Surgical Intervention Part One Chronic Conditions C1D C1DC Other Medical Conditions Unknown
Note: Even though no record is kept of follow-up care, acute care providers usually conduct follow-up visits after all illnesses have cleared, or most have resolved, resulting in some form of record to support these frequent visits. Given the small percentage of the population that suffers from chronic conditions, frequent documentation of the clinical outcomes is needed to track their clinical trends and to assess health-related outcomes of these rare chronic conditions. Long-term Care Process & What Should Be Done
Health Services, Non-Medical Conditions,
Request for Medical Care or Referral Not Required Not Required Request for Medical Care or Referral Accepted Accepted Medical Assistance Accepted Request for Medical Care or Referral Not Required Accepted Medical Assistance Not Required Requirement Not Required Not Required
Note: The CSAT form is considered to be a "limited form" of reporting chronic conditions to the Social Services Administration. Only the following information should be submitted, in the order listed: No information
Comprehensive Medical Care List Receipt No information
Note: Should the CSAT form be approved, it can be provided to the physician who prescribed the chronic care. The CSAT form should not be used to gather information for the physician to complete an appointment.
Provider Number Long Term Care System Board One Long Term Care System Board
Address Line 1 Address Line 1
Full Name Address Line 1
Daytime Telephone Number E-mail Address Address Electronic Address
Phone Number The nursing facility or provider will determine if the information is necessary to conduct a care assessment, such as when you arrive at the facility or return to a permanent residence.
The medical provider will typically request that you complete the CSAT form (or require the information to be entered electronically) before evaluating your medical condition, performing surgery, performing treatment for your illness, or evaluating your overall health.
Obtain Health Insurance Coverage Your insurance coverage is generally indicated on the CSAT form. The information included on the CSAT form should be a simple summary of your insurance coverage. The basic details of your insurance coverage will assist the nursing facility or other health care providers with determining your clinical needs.