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GENERAL REFERRAL FORM To Schedule: (310) 423-8000 To Fax Orders: (310) 423-0137 Patient preps on reverse. Exam information: www.cedars-sinai.edu/ImagingPreps Patient Name: Date of Birth: MM/DD/YYY
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How to fill out cedars sinai referral form

How to fill out Cedars Sinai referral:
01
Start by obtaining the referral form from Cedars Sinai Medical Center. You can usually find this form on their website or request it from their office.
02
Gather all necessary information before filling out the referral. This may include the patient's personal details, medical history, insurance information, and the reason for the referral.
03
Begin filling out the form by providing the patient's full name, date of birth, and contact information. Make sure to double-check for any errors or typos.
04
Next, include the referring physician's information, including their name, specialty, and contact details. If you were recommended by a specific physician, be sure to mention their name as well.
05
Provide details about the patient's medical condition or reason for the referral. Be specific and include any relevant symptoms, diagnoses, or medical history that may aid in the referral process.
06
If the referral is for a specific specialist or department at Cedars Sinai, make sure to include this information on the form. If not, you can leave this section blank.
07
Fill in the patient's insurance information accurately, including the policy number, provider, and any necessary authorization codes or pre-approvals.
08
Review the completed referral form for any errors or missing information. Make sure everything is filled out correctly and legibly.
09
Once you are satisfied with the form, submit it to Cedars Sinai through the designated submission process. This may include mailing, faxing, or submitting the form in person at their office.
10
Keep a copy of the referral form for your records and for any future follow-up.
Who needs Cedars Sinai referral:
01
Patients who require specialized medical care beyond the capabilities of their primary care physician may need a referral to Cedars Sinai.
02
Individuals seeking specialized diagnostic tests or procedures that are only available at Cedars Sinai may also require a referral.
03
Patients who have been diagnosed with a specific medical condition and require treatment or consultations from experts in that field may need a referral to Cedars Sinai.
04
Health insurance plans often require a referral from a primary care physician before covering specialty visits or procedures at Cedars Sinai, so patients covered by these plans may need a referral.
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What is cedars sinai referral?
Cedars Sinai referral is a process of referring patients to Cedars Sinai Medical Center for specialized treatment or services.
Who is required to file cedars sinai referral?
Healthcare providers, physicians, or insurance companies may be required to file Cedars Sinai referrals depending on the patient's insurance plan or healthcare needs.
How to fill out cedars sinai referral?
Cedars Sinai referral forms can typically be completed online, through fax, or by contacting the Cedars Sinai referral department directly.
What is the purpose of cedars sinai referral?
The purpose of Cedars Sinai referral is to ensure that patients receive specialized care or treatment available at Cedars Sinai Medical Center.
What information must be reported on cedars sinai referral?
Cedars Sinai referrals typically require patient demographics, reason for referral, insurance information, and relevant medical records.
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