Request for Referral – Dental / Medical Conditions Sample Clauses

Request for Referral – Dental / Medical Conditions. 1. For conditions where there is an overlap of medical and dental concerns, head and neck conditions (other than dental conditions, above) or for complex conditions where involvement of dental and medical practitioners in the Inmates care are anticipated. 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 is then forwarded to MT DOC Medical Director through the MT DOC Managed Care Nurse. 4. If approved, approved Inmate is scheduled with outside practitioner or specialist by the medical staff member designated to schedule off-site appointments. 5. The inmate is placed on the Inmate Treatment Follow-up List to allow for tracking of inmates scheduled for a consultation or treatment with an outside health care provider. In addition, this ensures post-referral follow- up care is completed. 6. In an Emergent situation, referral or direct consultation with a medical provider should be considered. 7. Notation is made in the Daily Treatment Sheet in the inmate’s dental charts concerning the referral.
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