Get Sihca

Filling out the Sihca referral/authorization request form online can streamline the process for both patients and healthcare providers. This guide will assist you in understanding each section of the form and provide clear, step-by-step instructions to ensure accurate completion.

Follow the steps to effectively complete the form online.

1. Press the ‘Get Form’ button to retrieve the Sihca form and access it for editing.
2. Begin by entering the patient’s name in the designated field. Ensure that this information matches their official documents.
3. Fill in the member ID number, which is necessary for identifying the patient within the Sihca system.
4. Specify the primary care physician's name to facilitate communication regarding patient care.
5. Provide the patient’s birth date to confirm their identity and eligibility.
6. Enter the fax number where the form will be sent for authorizations.
7. The primary care physician should enter their details, including the specialty physician to whom the referral is being sent.
8. Indicate the diagnosis codes relevant to the patient's condition for proper processing by the specialty physician.
9. Choose the duration for which the services are requested, selecting from 30, 60, or 90 days.
10. Specify the number of visits requested based on the evaluation condition outlined in the form.
11. Complete the signature section for both the primary care physician and the specialty physician to authorize the referrals.
12. After filling out all necessary fields, ensure to save changes, and download or print the completed form for submission.

Complete your documents online to ensure a smooth referral process.