Alameda Care Management Programs Referral Form 2019-2025 free printable template

Case Management Programs Referral Form Thank you for your interest in referring your Alameda Alliance for Health (Alliance) member patients to our case management program. INSTRUCTIONS 1. Please return

How to fill out Alameda Care Management Programs Referral Form

How to fill out Alameda Care Management Programs Referral Form

1. Start by downloading the Alameda Care Management Programs Referral Form from the official website.
2. Fill in the patient's personal information, including name, date of birth, and contact details.
3. Provide information about the referring party, including name, relationship to the patient, and contact information.
4. Describe the specific concerns or issues that necessitate the referral.
5. Include any relevant medical history or current treatments that the patient is undergoing.
6. Sign and date the form to confirm that the information provided is accurate.
7. Submit the completed form via email or fax to the designated contact listed on the form.

Who needs Alameda Care Management Programs Referral Form?

1. Individuals seeking assistance with healthcare management and coordination.
2. Patients who require support due to complex medical conditions or social issues.
3. Caregivers and family members looking to access care management services for their loved ones.

People Also Ask about

What is the maximum income to qualify for Medi-Cal 2023?

In 2023, the MMNA in CA is $3,715.50 / month. If a non-applicant's monthly income is under this amount, income can be transferred to them from their applicant spouse to bring their income up to $3,715.50.

What is the income limit for Medi-Cal in Alameda County?

Beginning July 1, 2022, the asset limit for Non-Modified Adjusted Gross Income (Non-MAGI) Medi-Cal programs increased to $130,000 for a household of one person and $195,000 for a household of two people.

What is the phone number for Alameda Alliance Beacon?

Alameda Alliance/Beacon: 855-856-0577.

Is Alameda Alliance the same as Medi-Cal?

Welcome to the Alliance! Thank you for joining Alameda Alliance for Health (Alliance). The Alliance is a health plan for people who have Medi-Cal. The Alliance works with the State of California to help you get the health care you need.

What is the maximum income to qualify for Medi-Cal assistance in CA?

ing to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.

What is the phone number for Alameda Alliance prior authorization?

Call your prospective doctor or clinic, medical group, independent practice association, or call Alameda Alliance for Health at 510.747. 4567 to ensure that you can obtain the health care services that you need.

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What is Alameda Care Management Programs Referral Form?

The Alameda Care Management Programs Referral Form is a document used to refer individuals to care management services provided by Alameda County, aimed at coordinating medical, social, and behavioral health services.

Who is required to file Alameda Care Management Programs Referral Form?

Healthcare providers, social workers, and other professionals involved in the care of individuals who may benefit from care management services are required to file the Alameda Care Management Programs Referral Form.

How to fill out Alameda Care Management Programs Referral Form?

To fill out the Alameda Care Management Programs Referral Form, complete the required sections with accurate information about the individual being referred, including personal details, medical history, and specific services needed before submitting it to the appropriate care management team.

What is the purpose of Alameda Care Management Programs Referral Form?

The purpose of the Alameda Care Management Programs Referral Form is to facilitate access to care management services by providing essential information needed to assess the individual's needs and coordinate appropriate support.

What information must be reported on Alameda Care Management Programs Referral Form?

The information that must be reported on the Alameda Care Management Programs Referral Form includes the individual's name, contact details, date of birth, medical history, current health concerns, and any specific needs or requested services.