Get Soonercare Referral Form

Filling out the Soonercare Referral Form online is a straightforward process that ensures proper communication between healthcare providers. This guide will provide you with detailed steps to help you accurately complete the form and submit it for effective processing.

Follow the steps to complete the referral form successfully.

1. Click ‘Get Form’ button to retrieve the Soonercare Referral Form and open it in the editing interface.
2. Begin by entering the member's details in the designated fields. Include the member's last name, first name, and middle initial in the appropriate boxes. Ensure that the member's ID number and phone number are correctly filled out. Provide the member's date of birth in the format 00/00/0000.
3. Next, refer the individual to a current SoonerCare provider. Input the provider's name, phone number, fax number, and address in the specified sections. Be sure to include the dates for which the referral is valid, with the start date not exceeding six months retrospectively and the end date not exceeding a total of 12 months.
4. In the 'Reason for Referral' section, clearly state the medical reason for the referral to inform the receiving provider.
5. Complete the 'Referred By' section by filling in the medical home provider's name and phone number. Include the name and signature of the referring provider along with their ID number and NPI number, ensuring all fields are filled accurately.
6. Once all sections of the form have been thoroughly completed, review the information for accuracy. Save any changes made during the process.
7. Finally, you can download or print the form for submission. Ensure that the original copy is mailed or faxed to the provider to whom the referral is being directed, and keep a duplicate for your records.

Complete your Soonercare Referral Form online today to ensure efficient processing of referrals!