Partnership Authorization request

Before requesting a Partnership authorization be sure to verify that it is not one of the following counties: Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Shasta, Siskiyou, Solano, Sonoma, Trinity, Butte, Placer, and Yolo. If it is, a RAF might not be required.

Example:

Example for when a patient needs to be referred to have a CT scan/MRI done : When it is in the "Yolo" county, CCS elig. is labeled as "No", check the PCP Name/Prgm No. If it is WOODLAND MEMORIAL HOSP /Medi-Cal, the patient will need to be referred to the appropriate facility in this case Woodland healthcare, Call (530) 668-2600 for further instructions.

• Make sure the patient is not eligible for CCS before requesting.
• Use the link below to complete the RAF request and fax to the appropriate PCP for approval.
• See the following title when confirming PCP details:

(If you are confused on which CPT codes need to be requested please view the following article.)

http://www.partnershiphp.org/providers/healthservices/documents/erafrequestform.pdf

Tip: Calling the PCP is a lot faster.