Search results with tag "Partnershiphp"
Napa County Medi-Cal Provider Directory
www.partnershiphp.orgMedi-Cal Provider Directory Napa County CONTACT US (800) 863-4155 | http://www.partnershiphp.org Revised Date: August 17, 2018 …
eRAF Request Form - Partnership HealthPlan
www.partnershiphp.orgEureka | Fairfield | Redding | Santa Rosa (707) 863-4100 | www.partnershiphp.org eRaf Request Form August 2017 . Purpose Use the eRAF request form to facilitate communication between Specialists and PCPs.
REQUEST FORM (TAR)
www.partnershiphp.org4665 BusinessTREATMENT AUTHORIZATION Center D rive Fairfiel d CA 94534 (707) 863-4133 or (800) 863-4 144 FAX # (707) 863-4118 www.partnershiphp.org. MEDI-CAL. REQUEST FORM (TAR) Author: CMcCamey Created Date:
PHC TAR REQUIREMENTS - partnershiphp.org
www.partnershiphp.orgAttachment A - MCUP3041 Attachment A - MCUP3049 Attachment B - MCUG3007 Revised 10/13/2021 [Treatment Authorization Request (TAR) to be submitted by the provider performing these services] Page 3 of 10 PHC TAR REQUIREMENTS Z. Medical Supplies 1. Diabetic Supplies are provided by Pharmacies ONLY. See note below regarding Medi-Cal Rx * 2.