Care Gap Closure Form

What Is Care Gap Closure Form?

A care gap closure form template is used by healthcare practices to identify missing screenings, vaccinations, follow-ups, and preventive services in a patient’s care history. Clinics use this care gap closure form template example for clinics to improve quality reporting, support population health goals, and ensure timely completion of overdue care tasks.

Purpose Of The Care Gap Closure Form

The care gap closure form template helps healthcare teams identify, document, and close gaps in essential preventive or chronic care services. It supports payer program compliance, improves value-based care scores, and reduces the risk of undetected conditions by ensuring timely screenings and follow-ups. By organizing overdue tasks in one standardized document, the form enhances workflow efficiency, reduces missed opportunities, and streamlines clinical outreach. Practices often pair this process with automated communication tools, such as medical practice texting, to ensure patients receive and act on reminders promptly.

Key Components Of The Care Gap Closure Form

A care gap closure form template helps practices maintain accurate quality-data documentation and streamline reporting requirements.

• Patient Information: Basic identification details for accurate tracking.
• Care Gaps Identified: Specific screenings, labs, or visits overdue.
• Diagnosis List: Relevant conditions tied to quality measures.
• Required Actions: Tasks needed to close each identified gap.
• Responsible Provider: Assigned clinician or care coordinator.
• Patient Outreach Status: Notes from calls, texts, or follow-ups.
• Completed Actions: Documentation of resolved care gaps.
• Supporting Evidence: Lab reports, visit notes, or screening results.
• Next Review Date: Scheduled reassessment for remaining gaps.
• Clinician Signature: Verification of accuracy and completion.

Digitize Your Medical Forms with Emitrr

Digitizing your care gap closure form template with Emitrr allows practices to fill out the care gap closure form template pdf form online, improving data accuracy and care-gap tracking across teams.

Emitrr’s HIPAA-compliant forms via text enables staff to quickly reach patients, gather updates, and confirm completed screenings. Seamless system integrations ensure every care gap closure entry syncs into your practice’s EHR or reporting system, reducing manual documentation and errors.

Every care gap closure form template built in Emitrr is HIPAA-compliant, supporting secure documentation needed for audits, payer programs, and value-based care performance reporting.

Clinics can also extend workflows by accessing additional 100+ free medical form templates and digital tools through Emitrr, improving operational efficiency and population health outcomes.

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