Get the free WYhealth Care Management Referral Form

WY health Care Management Referral Formulaic/patient information: Name: DOB: Medicaid #: Address: City:, WY Zip: Phone Number(s): (h) © Parent/Guardian: Phone Number: Primary language:English SpanishOther:

How to fill out wyhealth care management referral

How to fill out wyhealth care management referral

1. To fill out the wyhealth care management referral, follow these steps:
2. Obtain the referral form from your healthcare provider or the wyhealth care management program.
3. Fill in the patient's personal information, such as name, date of birth, and contact details.
4. Provide the details of the referring healthcare provider, including their name, clinic or hospital name, and contact information.
5. Fill out the patient's medical history and any relevant diagnoses or conditions that require care management.
6. Indicate the reason for the referral and the desired outcomes of the care management program.
7. Sign and date the referral form.
8. Submit the completed referral form to the wyhealth care management program via mail, fax, or electronic submission, as instructed.
9. Keep a copy of the referral form for your records.
10. Await confirmation of the referral and further instructions from the wyhealth care management program.

Who needs wyhealth care management referral?

1. The wyhealth care management referral is typically required for individuals with complex healthcare needs or chronic conditions that require additional support and coordination of care.
2. This may include patients with multiple chronic conditions, mental health concerns, high-risk pregnancies, or individuals in need of palliative or end-of-life care.
3. The referral helps ensure that these individuals receive comprehensive care management services to optimize their health outcomes and enhance their overall well-being.

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What is wyhealth care management referral?

Wyhealth care management referral is a formal request to seek specialized care or services for patients under the Wyoming health care management program.

Who is required to file wyhealth care management referral?

Health care providers who are part of the Wyoming health care management program are required to file the referral on behalf of their patients.

How to fill out wyhealth care management referral?

To fill out a wyhealth care management referral, providers need to complete the designated referral form with patient information, the reason for referral, and any relevant medical history, ensuring all sections are accurately filled out.

What is the purpose of wyhealth care management referral?

The purpose of wyhealth care management referral is to facilitate access to specialized medical services and ensure that patients receive appropriate care in a timely manner.

What information must be reported on wyhealth care management referral?

The referral must include the patient’s personal information, the referring provider's details, the specialty needed, the reason for the referral, and any supporting medical documentation.