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Annex G: Coordinated Referral and Transfer Form Revised as of September 2022Republic of the PhilippinesPHILIPPINE HEALTH INSURANCE CORPORATION City state Center, 709 Shaw Boulevard, PSIG City Call
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How to fill out coordinated referral and transfer

01
Gather all relevant information about the patient including medical history, current diagnosis, and treatment plan.
02
Contact the referring healthcare provider to discuss the need for a coordinated referral and transfer.
03
Complete any necessary paperwork or electronic forms required for the referral and transfer process.
04
Communicate with the receiving healthcare facility to ensure a smooth transition for the patient.
05
Follow up with both the referring and receiving healthcare providers to ensure the patient's care is coordinated effectively.

Who needs coordinated referral and transfer?

01
Patients who require specialized care that is not available at their current healthcare provider.
02
Healthcare providers who are looking to transfer a patient to a higher level of care for better treatment options.
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Coordinated referral and transfer is a process that ensures seamless communication and transfer of patients between different healthcare providers.
Healthcare providers such as hospitals, clinics, and medical facilities are required to file coordinated referral and transfer.
Coordinated referral and transfer forms can be filled out electronically or manually, following the specific instructions provided by the healthcare facility.
The purpose of coordinated referral and transfer is to ensure that patients receive timely and appropriate care by facilitating the transfer of medical records and information between healthcare providers.
Information such as patient demographics, medical history, current diagnosis, treatments received, and reason for transfer must be reported on coordinated referral and transfer forms.
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