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Get the free Specialist Referrals and Procedures, InjectionInfusion Request Form.docx

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Submitrequestsdirectlythrough CIM(cim6.phtech.com). Orfaxformto5033455770or8002707737Requestfor: SpecialistReferralsProcedures Inject onsandInfusions URGENTWerequiredocumentationtosupporthowmembersconditionmeetstheURGENTcriteriaasdefinedbelow.
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Specialist referrals and procedures are processes where a primary care provider refers a patient to a specialist for further evaluation or treatment.
The primary care provider is typically required to file specialist referrals and procedures.
To fill out specialist referrals and procedures, the primary care provider needs to complete the necessary paperwork and provide relevant medical information about the patient.
The purpose of specialist referrals and procedures is to ensure that patients receive the appropriate care and treatment from specialists who have expertise in specific medical areas.
The information reported on specialist referrals and procedures typically includes the patient's medical history, reason for the referral, and any relevant test results.
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