Get the free SEC-137A Physician's referral for homebound instruction ( ... - webapps1 philasd

DREJTORIA ARSIMORE E FILADELFIASThe School District of Philadelphia SHERBIMI SHENDETESOR I SHKOLLESSchool Health Services Referimi i Mjekut pr Udhzimet qKryhen nShtpi/Physicians Referral for Homebound

How to fill out sec-137a physicians referral for

How to fill out sec-137a physicians referral for

1. Obtain a blank SEC-137A referral form from the relevant healthcare provider or online.
2. Fill out the patient's personal information, including name, date of birth, and insurance details at the top of the form.
3. Provide the referring physician's information, including name, contact number, and practice address.
4. Indicate the specialist or healthcare provider the patient is being referred to by writing their details in the appropriate section.
5. Specify the reason for the referral in the designated area, clearly outlining the patient's condition or symptoms.
6. Sign and date the form to authenticate the referral.
7. Provide a copy of the completed referral to the patient and keep a copy for your records.

Who needs sec-137a physicians referral for?

1. Patients who require specialized medical care that cannot be provided by their primary care physician.
2. Individuals who are seeking access to specialists for consultations, diagnostics, or treatment.
3. Persons seeking referrals for insurance purposes to ensure coverage for specialist services.

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What is sec-137a physicians referral for?

Section 137a physicians referral is designed to document the referral of patients from one physician to another, ensuring continuity of care and appropriate health service delivery.

Who is required to file sec-137a physicians referral for?

Physicians who refer patients to other specialists or healthcare providers are required to file a sec-137a physicians referral.

How to fill out sec-137a physicians referral for?

To fill out a sec-137a physicians referral, the referring physician must provide patient information, the name of the referred physician, the reason for referral, and any relevant medical history.

What is the purpose of sec-137a physicians referral for?

The purpose of sec-137a physicians referral is to facilitate coordinated patient care, ensure that necessary medical services are provided, and maintain comprehensive medical records.

What information must be reported on sec-137a physicians referral for?

The information required includes patient identification details, referring and referred physician information, the purpose of the referral, and any pertinent medical records or notes.