Is a Referral Card physically required for Managed Care recipients?
No. A proper referral can be provided in many ways, i.e. a telephone referral, a physician order, a prescription, a certificate of medical necessity, etc. As long as the referral mechanism used provides the “referred to” medical provider with the Managed Care necessary information to process the claim as indicated on a referral card (PCP name and #, length of referral, type of service to be provided, date, recipient name). The referral card is simply a tool indicating the required information needed by the “referred to” provider.
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