<Date>

<Member Name>

<Member Address>

Dear «Patientfullname»:

Thank you for taking the time to talk with me. The information you shared is important to help me know how to best support you in the way you want to be supported.

Enclosed are two copies of your care plan with your goals, services, and supports as we discussed. One copy is for you. Please sign the other and return it in the enclosed envelope within 14 days. If you have any questions or there's anything you need help with right away, please call me at HealthPartners < Select cm.contactphone >, otherwise you can expect a follow up phone call regarding your goals, services, and support.

I will also share your care plan with «ProviderFullName», «ProviderSiteDef3».

I look forward to talking with you again.

Feel free to contact me with any questions or concerns.

Sincerely,

«CaseOwnerFullName»

MSC+ Care Coordinator

HealthPartners Case Management

Enclosures: 2 care plans, MSC+ Appeal Rights, Statement of Nondiscrimination for Health Plan Members, Language Block, self-addressed stamped envelope

H2422_85219 IR 12/15/2014