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Member Management Referral Form An Independent Licensee of the Blue Cross and Blue Shield Association Please fax completed form to the appropriate area below **The numbers below are for CM referrals
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What is member management referral form?
The member management referral form is a document used to refer or recommend a member for management purposes.
Who is required to file member management referral form?
Any individual or entity responsible for managing members may be required to file the member management referral form.
How to fill out member management referral form?
To fill out the member management referral form, the required information should be provided in the designated fields of the form, including details about the member being referred and the reasons for the referral.
What is the purpose of member management referral form?
The purpose of the member management referral form is to formally recommend or refer a member for management purposes, such as highlighting their performance, potential, or need for specific management interventions.
What information must be reported on member management referral form?
The member management referral form typically requires information about the referred member, including their name, contact details, current role, reasons for the referral, and any supporting documentation or evidence.
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