REFERRAL GUIDE FOR SOONERCARE Oklahoma gov
Web SoonerCare referral form SC 10 Paper referrals with required information E mail referrals with required information Electronic referrals submitted through an electronic medical record EMR with required information A printed copy of an EMR referral with required information
SOONERCARE REFERRAL REQUEST Oklahoma gov, Web Prospective Administrative Referral Attn Care Management Phone 877 252 6002 Fax 405 213 1145 Number of Pages Please complete the information below to document your attempts to obtain a referral from the PCP CM Email Fax this completed form to SoonerCare One form per provider please
REFERRAL GUIDE FOR SOONERCARE PROVIDERS Oklahoma gov
Web Acceptable referral methods consist of SoonerCare referral form SC 10 A Paper referrals with required information E mail referrals with required information Electronic referrals submitted through an electronic medical record EMR with re quired information A printed copy of an EMR referral with required information
Forms Oklahoma gov, Web SoonerCare Insure Oklahoma Referral Form SC 13 Provider Action Form SC 14 SoonerCare Administrative Referral Request SC 15 English Spanish Parental Consent Form SC 16 English Spanish Change of Provider Request TPL 1 Third Party Liability Information Sheet
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Web Acceptable referral methods consist of but are not limited to SoonerCare Referral Form SC 10 Paper referrals with required components E mail referrals with required components Electronic referrals submitted through an electronic medical record EMR with required components SOONERCARE CHOICE REFERRALS Welcome To Oklahoma s . Web SOONERCARE REFERRAL REQUEST Please complete the information below to document your attempts to obtain a referral from the PCP CM Fax this completed form to SoonerCare Your referral request will be considered and you will receive written notice of approval or denial Include any necessary medical records Web SOONERCARE REFERRAL REQUEST Please complete the information below to document your attempts to obtain a referral from the PCP CM Fax this completed form to SoonerCare One form per provider please Your referral request will be considered and you will receive written notice of approval or denial Include any necessary medical records
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