Care Management Transition of Care Support

Experts to help ease your way

Providence Care Management assists members, member representatives, and practitioners during the transition from one health plan to another, change in benefit plan or upon termination of a practitioner’s relationship with Providence; each is reviewed on a case-by-case basis. Care Management’s Transition of Care Forms (questionnaire and release of information) are designed to alert our team to needs a member may have during their transition.

Support when needed

Not all members need Care Management Transition of Care support, but it may be helpful when:

  • You are a current member with a change to your coverage.
  • You are a new member and your current physical health or behavioral health provider is out of network and you do not have out of network benefits.
  • You are a new member and have an upcoming pre-approved procedure, treatment, and/or pregnancy.
  • You are a new member and need help with referrals and/or prior authorizations for needed care.

How to get started

To submit your Transition of Care Request, complete the following:

For more information or additional questions, read our FAQs below or contact us by phone at 503-574-7247 or 800-662-1121 (TTY: 711) Monday- Friday (8-5 PST) or email

How Care Management can help

Care Management helps members with clinical and non-clinical needs by:

  • Providing education about plan services and processes.
  • Assistance finding and establishing with new physical health or behavioral health providers.
  • Navigation to Pharmacy, Durable Medical equipment, Diabetic supplies, or other services or resources.
  • Care Coordination between multiple providers.
  • Any other healthcare navigation support needed during this transition.

Frequently asked questions

Note: Submitting a transition of care packet is not required. Members can choose to see providers at out of network rates if they have out of network benefits. Submitting a transition of care packet does not guarantee in-network rates. If a benefit exception request is submitted and in-network rates are approved, members may still be liable for any balance billing by the out of network provider. Decisions are based on medical necessity and not a guarantee of payment for services. Payment is based on eligibility and benefits at the time of service.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Webpage is current as of: 12/08/2023

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