Get the free MNHP Hearing Screening Referral Form

Department of Health and Human Services Maine Center for Disease Control and Prevention Children with Special Health Needs Maine Newborn Hearing Program 286 Water Street Augusta, Maine 043330011 Tel.:

How to fill out mnhp hearing screening referral

How to fill out mnhp hearing screening referral

1. To fill out the MNHP hearing screening referral, follow these steps:
2. Start by entering the patient's personal information such as name, date of birth, address, and contact details.
3. Provide insurance information, including the policy number and any relevant coverage details.
4. Indicate the reason for the referral and specify that it is for hearing screening.
5. Include any relevant medical history or notes that may be helpful for the screening process.
6. If necessary, attach any supporting documents or test results that are relevant to the referral.
7. Make sure to include the healthcare provider's information, such as name, contact details, and signature.
8. Double-check all the entered information for accuracy and completeness before submitting the referral.
9. Once the referral is complete, submit it to the appropriate department or healthcare provider for further processing and scheduling of the hearing screening.

Who needs mnhp hearing screening referral?

1. Individuals who require or would benefit from a hearing screening can be referred through the MNHP hearing screening referral.
2. This includes individuals who have recently experienced hearing difficulties, have a history of recurrent ear infections, or have been exposed to loud noises for extended periods.
3. Additionally, children who have not passed their newborn hearing screening or are at risk of hearing problems may also require a referral.
4. Consult with a healthcare professional or audiologist to determine if a referral for a hearing screening is necessary in specific cases.

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What is mnhp hearing screening referral?

The mnhp hearing screening referral is a form submitted by healthcare providers to the Minnesota Department of Health to report results of newborn hearing screenings.

Who is required to file mnhp hearing screening referral?

Healthcare providers, including hospitals, birthing centers, and audiologists, are required to file mnhp hearing screening referral.

How to fill out mnhp hearing screening referral?

Healthcare providers must include information such as the infant's demographics, screening results, and follow-up care recommendations on the mnhp hearing screening referral form.

What is the purpose of mnhp hearing screening referral?

The purpose of mnhp hearing screening referral is to ensure that newborns receive timely hearing screenings and follow-up care if needed.

What information must be reported on mnhp hearing screening referral?

Information such as infant's name, date of birth, screening results, date of screening, and provider information must be reported on mnhp hearing screening referral.