Get the free SCFHP Referral Authorization Form (RAF) - Santa Clara Family ...

Referral Authorization Form (RAF) P.O. Box 5550 San Jose, CA 95150-5550 Fax: 408-376-3532 Phone: 408-376-2000 Option #6 Automated Eligibility: 800-720-3455 The provider accepting this referral must

How to fill out scfhp referral authorization form

How to fill out scfhp referral authorization form:

1. Contact your healthcare provider to obtain the scfhp referral authorization form.
2. Read the instructions carefully and gather all necessary information and documents.
3. Fill out personal details such as name, address, contact information, and member ID.
4. Provide your healthcare provider's information, including name, address, and contact details.
5. Specify the reason for the referral and the specialist or healthcare service you are requesting.
6. Attach any supporting documents, such as medical reports or test results, if required.
7. Review all the information you have filled in to ensure accuracy and completeness.
8. Sign and date the form.
9. Submit the completed form to your healthcare provider or the appropriate scfhp department.

Who needs scfhp referral authorization form:

1. Individuals who are members of scfhp healthcare program.
2. Individuals who require a referral from their primary care physician to see a specialist or receive specific healthcare services covered by scfhp.
3. Individuals who want to access specialized medical care or services that are not available through their primary care provider.

For pdfFiller’s FAQs

What is scfhp referral authorization form?

The scfhp referral authorization form is a document that is used to request authorization for a referral from the Santa Clara Family Health Plan (SCFHP).

Who is required to file scfhp referral authorization form?

Healthcare providers who are participating in the SCFHP network and need to refer a patient to a specialist or for a specific medical service are required to file the scfhp referral authorization form.

How to fill out scfhp referral authorization form?

To fill out the scfhp referral authorization form, you will need to provide information about the patient, the referring healthcare provider, the specialist or service being requested, and any supporting documentation or clinical notes. The form can be obtained from the SCFHP website or through the provider portal.

What is the purpose of scfhp referral authorization form?

The purpose of the scfhp referral authorization form is to ensure that referrals for specialized medical services are medically necessary and appropriate, and to coordinate the provision of healthcare services for SCFHP members.

What information must be reported on scfhp referral authorization form?

The scfhp referral authorization form requires information such as the patient's demographic details, medical history, the referring healthcare provider's information, details of the specialist or service being requested, and any relevant clinical documentation.

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