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SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH CHILD HEALTH AND DISABILITY PREVENTION (CHIP) PROGRAMWinterSpring 20192020 DENTAL REFERRAL DIRECTORY MEDICAL (IDENTICAL)18003226384 REFERRAL TO IDENTICAL
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How to fill out referral to denti-cal dentist
How to fill out referral to denti-cal dentist
01
To fill out a referral to a Denti-Cal dentist, follow these steps: 1. Obtain a referral form from your primary care dentist or Denti-Cal program. 2. Complete the patient information section on the referral form, including your name, contact information, and Denti-Cal identification number. 3. Provide information about your primary care dentist, including their name and contact information. 4. Indicate the reason for the referral and specify any specific treatments or procedures needed. 5. Sign and date the referral form. 6. Submit the referral form to your primary care dentist or directly to the Denti-Cal program, as instructed.
Who needs referral to denti-cal dentist?
01
Anyone who is enrolled in the Denti-Cal program and requires specialized dental treatments or procedures that cannot be provided by their primary care dentist may need a referral to a Denti-Cal dentist. Additionally, individuals who need emergency dental care or certain specialty services such as orthodontics may also require a referral.
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What is referral to denti-cal dentist?
Referral to a Denti-Cal dentist is a recommendation from a primary care provider to see a dentist who accepts Denti-Cal insurance.
Who is required to file referral to denti-cal dentist?
Primary care providers are required to file a referral to a Denti-Cal dentist for their patients.
How to fill out referral to denti-cal dentist?
The referral to a Denti-Cal dentist can be filled out by the primary care provider and submitted to the dentist chosen by the patient.
What is the purpose of referral to denti-cal dentist?
The purpose of a referral to a Denti-Cal dentist is to ensure that patients can access dental care covered under their Denti-Cal insurance.
What information must be reported on referral to denti-cal dentist?
The referral should include the patient's information, reason for the referral, and any relevant medical history.
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