Partnership Health Plan Referral Form

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Medi-Cal Referral Authorization Form (RAF) - Partnership …

(3 days ago) WEBReferral Authorization Form (RAF) Signature / Print Name Date Seen Phone No. Fax No. ID#: If Non-Contracted provider, RAF must be approved by PHC PARTNERSHIP …

http://www.partnershiphp.org/Providers/HealthServices/Documents/MediCal_RAFForm.pdf

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Beacon Health Options/Partnership Health Plan Primary Care …

(3 days ago) WEBFax form to: 866.422.3413. OR secure email: [email protected] ☐ Referral for Local Care Management: Local behavioral health care coordination …

http://www.partnershiphp.org/Providers/HealthServices/Documents/MentalHealth/Beacon_PCPReferralForm.pdf

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PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY / …

(9 days ago) WEBTo describe the procedure used by the Partnership HealthPlan of California (PHC) Utilization Management (UM) Department to process Referral Authorization Forms …

https://public.powerdms.com/PHC/documents/1850203

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Provider Relations

(8 days ago) WEBThe department is responsible for contracting, credentialing, provider education and the Provider Directory. If you have any questions, please reach out to a Provider Relations …

https://phcwebsite2016.partnershiphp.org/Providers/Medi-Cal/Pages/default.aspx

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Enhanced Care Management (ECM) Referral Avenues

(8 days ago) WEBPartnership HealthPlan of California members with complex health and/or social needs. Members enrolled in ECM will primarily receive in-person care management

https://phcwebsite2016.partnershiphp.org/Community/Documents/CalAIM%20Webpage/ECM%20Documents/Resources/ECM%20Referral%20Avenues_Final.pdf

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PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY / …

(9 days ago) WEBTo describe Partnership HealthPlan of California’s (PHC’s) process for reviewing and authorizing requests for the Enhanced Care Management (ECM) benefit and optional …

https://public.powerdms.com/PHC/documents/2397870

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Partnership HealthPlan of California - NorCal

(5 days ago) WEBNone. Programs at this agency. Partnership - Growing Together Program Partnership - Behavioral Health Partnership - Wellness and Recovery Program. …

https://www.icarol.info/ResultDetails.aspx?org=2273&agencynum=14495777&sitenum=14496635

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PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY/ …

(9 days ago) WEBdirect referral to a specialist, without being subject to PHC’s Referral Authorization Form (RAF) process. (See policy MCCP2024 Whole Child Model for California Children’s …

https://public.powerdms.com/PHC/documents/1850080

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PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY / …

(9 days ago) WEBB. PHC Provider Network: Providers that are contracted with Partnership HealthPlan. C. Referral Authorization Form (RAF) process: is defined as the process by which the …

https://public.powerdms.com/PHC/documents/1850094

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Partnership HealthPlan of California

(4 days ago) WEBFirst Login. When your eAdmin created your user account, you received an email with your username, a temporary password, and a link to the login page. Click the link in the …

https://provider.partnershiphp.org/UserGuides/UserGuide_Authorizations.pdf

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Carelon Behavioral Health Partnership Health Plan Primary …

(4 days ago) WEBincluding parents and guardians. If possible, please send this referral form along with a completed release of information for anyone who may be involved in the member’s care. …

https://www.carelonbehavioralhealth.com/content/dam/digital/carelon/cbh-assets/documents/ca/partnership-health-plan-of-california/pcp-referral-form-updated-phpc.pdf

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PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY/ …

(9 days ago) WEBF. RAF: Referral Authorization Form – The primary care provider (PCP) submits a RAF to Partnership HealthPlan of California (PHC) to refer a PHC member to a specialist for …

https://public.powerdms.com/PHC/documents/1850178

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Forms and Guides for CA Carelon Behavioral Health

(9 days ago) WEBBehavioral Health Care Management Referral Form Care Management Referral Form Primary Care Provider (PCP) Referral Form Contact Information: Carelon Behavioral …

https://www.carelonbehavioralhealth.com/providers/forms-and-guides/ca

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Prior Authorizations :: The Health Plan

(6 days ago) WEBPrior Authorization Request Forms. Medical Prior Authorization Request Form. Molecular Pathology Request Form. Electronic Claim Fax Cover Sheet. Prior Authorization for …

https://www.healthplan.org/providers/prior-authorization-referrals/forms-prior-auth-list-notices

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