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Precertify |
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In
order to assist you with pre- certifying a patient quickly, easily
and confidentially, we have provided a Precertification/
Referral
Form.
When you have completed the form, please fax it
directly to Gordian Health Management.
Note:
Faxing this form insures security
when sending confidential patient information. |
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We make managed care
simple!
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Step 1> Download the
Precertification/Referral Form by saving the form to your hard drive or
print directly from your browser.
Step
2> Complete the information required in the
Precertification/Referral Form.
Step
3> Fax directly to Gordian Health Management Group
at 817.332.7646 or Metro Fax - 972.299.5669.
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Download
Form |
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The Precertification/
Referral Form is a .pdf
(portable document file) which requires Adobe's Acrobat
Reader. If you have Acrobat Reader installed, this form is downloadable,
printable and viewable in your browser. If you don't have
Acrobat Reader installed, get the latest version FREE
now.
Download
Now
If you have any questions, please call
817.877.0770
Metro
972.299.5668 or Toll-Free - 1.800.957.5668
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