Request for Referral – Dental Conditions Sample Clauses

Request for Referral – Dental Conditions. 1. For conditions involving primarily the oral, dental or maxilla-facial region. 2. MSP dental staff submits a recommendation for a referral to an outside practitioner or specialist utilizing the MT DOC Clinical Services Department Preauthorization Request Form. 3. The referral request is forwarded, along with documentation and radiographs to the Director, Dental Services. The request may be forwarded by the Director, Dental Services, to the Dental Services Review Committee if appropriate. 4. The Director, Dental Services, determines if the treatment, diagnostic consultation or laboratory services are necessary, whether the services could be accomplished by a member of the MSP dental staff, or approves the referral request to an outside practitioner or specialist. 5. A copy of the approved or denied referral request is forwarded to the MT DOC Managed Care Nurse. 6. The Director, Dental Services, forwards the request to the medical staff member designated to schedule off-site appointments. 7. The inmate is placed on the Inmate Treatment Follow-up List. This allows for tracking of inmates scheduled for a consultation or treatment with an outside dentist or other health care provider. In addition, this ensures post- referral follow-up care is completed. 8. Notation is made in the Daily Treatment Sheet in the inmate’s dental charts concerning the referral.
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Request for Referral – Dental Conditions. For conditions involving primarily the oral, dental or maxilla-facial region.
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Related to Request for Referral – Dental Conditions

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