Get the free REFERRALS-NeurologyReferralList-rev-10-22-15-exp-12-31-15 - alzoc

Alzheimer's Orange County 2515 McCabe Way, Suite 200 Irvine, CA 92614 844.373.4400 www.alzoc.org Physician Referral List This list is for referral purposes only and is not exhaustive. The following

How to fill out referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc

How to fill out referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc:

1. Begin by entering the date of referral in the designated field.
2. Next, provide the patient's full name, including their first name, middle name (if applicable), and last name.
3. Include the patient's date of birth to ensure accurate identification.
4. Fill in the patient's contact information, including their address, phone number, and email address (if available).
5. Indicate the referring physician by entering their name, contact number, and fax number.
6. Enter the name of the primary care physician (PCP) or referring medical group responsible for managing the patient's care.
7. Specify the reason for the referral, providing a brief explanation of the patient's condition or symptoms.
8. If applicable, provide any relevant diagnostic codes, such as ICD-10 codes, for better understanding and coordination of care.
9. Include any relevant medical history or previous treatments the patient has undergone that may be helpful for the neurologist.
10. If the patient has insurance, indicate the type of insurance and include any necessary insurance information, such as policy numbers or group numbers.
11. Finally, sign and date the referral form to authenticate it.

Who needs referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc?

1. Patients experiencing neurological symptoms or conditions who require specialized consultation or treatment from a neurologist.
2. Primary care physicians or medical professionals who have identified potential neurological issues in their patients and seek expert advice or intervention.
3. Insurance companies or healthcare organizations managing the patient's care and coordinating specialist referrals.

Please note that this specific referral form, referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc, may be specific to a certain organization or healthcare network, so it is essential to refer to the appropriate form provided by the relevant entity.

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What is referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc?

This refers to a list of referrals for neurology services with a revision date of 10-22-15 and an expiration date of 12-31-15 specifically for ALZOC.

Who is required to file referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc?

Healthcare providers and institutions requiring referrals for neurology services at ALZOC are required to file this list.

How to fill out referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc?

The list must be completed with the necessary information on patients requiring neurology referrals and must be submitted to ALZOC before the expiration date.

What is the purpose of referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc?

The purpose of this list is to facilitate the process of referring patients for neurology services at ALZOC.

What information must be reported on referrals-neurologyreferrallist-rev-10-22-15-exp-12-31-15 - alzoc?

The list must include patient names, contact information, reason for referral, referring physician, and any relevant medical history.