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CALIFORNIA AREA IHS Youth Regional Treatment Center Network YRTCN RISK POOL REFERRAL FORM REFERRANT INFORMATION Referring program Referring counselor CLIENT DEMOGRAPHICS Date of Birth Client initials Gender Tribe REASON FOR REFERRAL Primary drug of choice Secondary drug of choice Tertiary drug of choice Frequency of substance use How much per episode Areas of psychosocial impairment Reason cannot be treated in less restrictive environment Residential facility requested Daily rate Tentative...
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What is ihs risk pool referral?
IHS risk pool referral is a process where individuals or facilities refer patients to the Indian Health Service (IHS) risk pool for specialized medical care.
Who is required to file ihs risk pool referral?
Healthcare providers or facilities that are part of the Indian Health Service (IHS) network are required to file IHS risk pool referrals.
How to fill out ihs risk pool referral?
To fill out an IHS risk pool referral, healthcare providers or facilities must complete the necessary forms provided by the IHS and submit them with the relevant patient information.
What is the purpose of ihs risk pool referral?
The purpose of an IHS risk pool referral is to ensure that patients who require specialized medical care not available within the IHS network can receive treatment through the risk pool.
What information must be reported on ihs risk pool referral?
An IHS risk pool referral must include the patient's medical condition, the requested medical services, supporting documentation, and any other relevant information specified by the IHS.
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