|
If a member wants to be seen, but he or she has not obtained the necessary authorization or referral from his/her primary care physician (PCP), have him or her complete the Acknowledgment Medical Services form. NOTE: The Acknowledgment Medical Services form is being revised and will be replaced later in September.
A separate form is required for each date of service. Use the Acknowledgment Form or your office's equivalent when:
If your office uses a different form, it must be date-of-service specific (not a general waiver) and include this information:
Last modified
09/29/08
|
