Get the free Oregon Health Plan Care Coordination Referral Form - ohsu

A form used to refer clients into the Oregon Health Plan Care Coordination Program, detailing patient and provider information for care coordination.

How to fill out oregon health plan care

How to fill out Oregon Health Plan Care Coordination Referral Form

1. Obtain the Oregon Health Plan Care Coordination Referral Form from the official website or your healthcare provider.
2. Fill out the patient's identification information at the top of the form, including name, date of birth, and OHP ID number.
3. Indicate the reason for the referral in the designated section, providing specific details about the patient's needs.
4. Complete the section for referring provider information, including name, contact details, and provider's NPI number.
5. Provide any relevant medical history and additional notes that may assist in care coordination.
6. Review the completed form for accuracy and ensure all required fields are filled out.
7. Submit the form through the specified channel, which could be via fax, email, or in-person submission as per instructions.

Who needs Oregon Health Plan Care Coordination Referral Form?

1. Individuals enrolled in the Oregon Health Plan who require additional care coordination services.
2. Patients with complex health needs that require collaboration among multiple healthcare providers.
3. People accessing specialized services that are not managed by their primary care provider.

For pdfFiller’s FAQs

What is Oregon Health Plan Care Coordination Referral Form?

The Oregon Health Plan Care Coordination Referral Form is a document used to facilitate communication and coordination of care among healthcare providers for individuals enrolled in the Oregon Health Plan.

Who is required to file Oregon Health Plan Care Coordination Referral Form?

Healthcare providers involved in the care of Oregon Health Plan members are typically required to file the Care Coordination Referral Form to ensure comprehensive care management.

How to fill out Oregon Health Plan Care Coordination Referral Form?

To fill out the Oregon Health Plan Care Coordination Referral Form, providers need to provide patient information, details about the service needed, and any relevant medical history or supporting documentation relevant to the referral.

What is the purpose of Oregon Health Plan Care Coordination Referral Form?

The purpose of the Oregon Health Plan Care Coordination Referral Form is to streamline the referral process, ensure that all necessary information is exchanged between healthcare providers, and improve the overall care experience for patients.

What information must be reported on Oregon Health Plan Care Coordination Referral Form?

The information that must be reported on the Oregon Health Plan Care Coordination Referral Form includes patient identification details, the reason for the referral, specific services required, and any pertinent medical history that could aid in care coordination.