Get the free Referral for Rehabilitation Services - Atlanta Hospitals - emoryhealthcare

Referral for Rehabilitation Services Patient Name Date of Surgery / Week Weeks ACL Reconstruction: Hamstring and BonePatella Bone Autografts Weeks 13 Begin: **DO NOT PUSH FLEXION PAST 90 DEGREES FOR

How to fill out referral for rehabilitation services

How to fill out a referral for rehabilitation services:

1. Begin by obtaining the necessary referral form from your primary care physician or healthcare provider.
2. Fill out your personal information accurately, including your full name, date of birth, address, and contact information.
3. Provide your insurance information, including the name of your insurance company, policy number, and any necessary authorization or pre-approval codes.
4. Write a detailed description of the reason for the referral, including any diagnoses, symptoms, or specific rehabilitation services required.
5. Include any relevant medical history or previous treatments, as well as any medications you are currently taking.
6. If you have a specific rehabilitation facility or specialist in mind, provide their name, contact information, and any other required details.
7. Make sure to sign and date the referral form before submitting it to your healthcare provider or insurance company.

Who needs a referral for rehabilitation services:

1. Individuals who have experienced an injury or illness that requires specialized rehabilitation services may need a referral.
2. Patients who have undergone surgery and require post-operative rehabilitation or physical therapy often need a referral.
3. Individuals with certain medical conditions, such as stroke, spinal cord injury, or sports injuries, may require rehabilitation services and thus need a referral.
4. In some cases, insurance companies or healthcare providers may require a referral before covering the costs of rehabilitation services. Therefore, anyone seeking insurance coverage for rehabilitation may need a referral.

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What is referral for rehabilitation services?

Referral for rehabilitation services is a request made by a healthcare provider or other relevant party to recommend a patient for rehabilitation services.

Who is required to file referral for rehabilitation services?

Healthcare providers, physicians, therapists, or other designated individuals are required to file referral for rehabilitation services.

How to fill out referral for rehabilitation services?

Referral for rehabilitation services can be filled out by providing the patient's information, medical history, diagnosis, and recommended treatment plan.

What is the purpose of referral for rehabilitation services?

The purpose of referral for rehabilitation services is to ensure patients receive the appropriate care and treatment to aid in their recovery and improve their quality of life.

What information must be reported on referral for rehabilitation services?

Information such as patient demographics, medical history, current diagnosis, recommended treatment plan, and healthcare provider contact information must be reported on referral for rehabilitation services.

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