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How to fill out the SCFHP Referral Authorization Form (RAF) - Santa Clara Family Health Plan online
Filling out the SCFHP Referral Authorization Form (RAF) online is a straightforward process that facilitates access to specialized healthcare services. This guide provides step-by-step instructions to ensure accurate completion of the form.
Follow the steps to complete the form accurately.
- Click 'Get Form' button to obtain the form and open it in the editor.
- Start by entering the patient information in the designated fields. Fill in the member's name, member ID number, date of birth, sex, and telephone number.
- Provide the primary care provider (PCP) information, including the PCP's name and SCFHP provider number, as well as their telephone number. If there is an on-call PCP, include their name and provider number as well.
- Next, fill in the referral physician or vendor information. Enter the provider's name, specialty or clinic department, medical group or clinic name, and their contact phone number.
- Include the provider's address in the specified section.
- Indicate the services requested by checking the appropriate box: whether it is for a consult only, consult and up to two follow-up visits, or a second opinion, and enter the relevant ICD-9 codes.
- Provide the reason for the referral or diagnosis in the designated field, which is essential for justifying the referral.
- Acknowledge that the PCP must sign the form, and record the issue date clearly.
- Finally, review the completed form for any errors or incomplete fields. Once satisfied, you may save changes, download, print, or share the form as needed.
Complete the SCFHP Referral Authorization Form online to expedite your referral process.
Almost all Medi-Cal plans are “managed care plans” which means they function similar to an HMO. Medi-Cal Plans can be found in the Medi-Cal Managed Care Health Plan Directory. A managed care plan means you'll have a primary care physician, and they're the one person you'll see if you need medical care.
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