Platinum Care Management is now Welltel Virtual Care

Home healthcare assessments

for home care agencies
and insurance companies

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ASSESSMENT FORMS

Getting the paperwork done that

keeps you giving

DOH 4359

Collects patient care info for home health agencies
Download PDF

DOH 485

DOH 485 Records patient details for home care services
Download PDF

NYIA

NYIA Used for healthcare insurance applications
Download PDF

M11Q

M11Q Assesses the need for long-term care in NY
Download PDF

CMS 485

CMS 485 Comprehensive nursing assessment for home care
Download PDF
CHAA
Assessments
CHAA forms are agency specific. Please email us your agency CHAA form at [email protected]

Essential benefits that

make it easy

Proprietary

tracking software

Multilingual

translator service

0%

out of pocket costs

24-hour

turnaround time

100%

client satisfaction

100%

HIPAA compliance

Welltel Telehealth Doctor

The Welltel

Advantage

The Department of Health requirements are vast, and the compliance list is long.
Case Managers can spend hours trying to reach patients to obtain required clinical data.

Meanwhile, the clock is ticking and submission deadlines are potentially missed, causing gaps in benefits and delayed payment.

Harnessing a cutting edge telehealth platform, Welltel submits completed documents and home health assessments within 24 hours, allowing your organization and patients to reap the benefits of:

trusted by agencies and MLTCS both small and large

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the welltel process

Rapid, 24-hour turnaround

1

Referral Submissions

Initial step where referrals for Welltel services are submitted and the process begins. 

2

Intake & Appointment Scheduling

Following referral submission, intake procedures are conducted, and appointments for assessments are scheduled.

3

Welltel Provider Assesment

Welltel providers assess the individual’s needs and determine appropriate care plans.

4

Home Health Assessment Form Completion

Necessary forms and documentation are completed during the assessment process and uploaded to the client’s portal within 24 hours of submission.

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