Get Partnership Raf

Filling out the Partnership Referral Authorization Form (RAF) online can streamline the referral process for healthcare services. This guide will provide you with clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete the Partnership Raf with ease.

1. Click the ‘Get Form’ button to obtain the Partnership Raf and open it in your online editor.
2. Enter the required information in the designated fields, starting with the member's name, date of birth, and identification number (ID#). Ensure all entries are accurate to avoid delays in processing.
3. Indicate the services requested by checking the appropriate boxes for consultations or continuing care. You may also specify the duration of the services required.
4. Provide the reason for the referral, along with any necessary information about the work-up and treatment the member has received to date. Attach relevant documents, such as lab reports and imaging studies.
5. Select the provisional diagnosis and enter the primary ICD-9 code if applicable. Ensure that this is accurate as it will influence treatment decisions.
6. After completing the clinician's section, ensure you sign and print your name. Include the date of issue.
7. Specify where the consultant should send the consult report, including the correct address, city, phone number, and fax number.
8. Once the consultant completes their section, ensure that all required signatures are provided, and that copies are appropriately distributed to the consultant, primary care provider (PCP), and Partnership HealthPlan of California (PHC).
9. Finally, review all information for accuracy before saving changes, downloading, printing, or sharing the completed form.

Complete your Partnership Raf online today to facilitate prompt healthcare referrals.