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Referral and Pharmacy Guidelines
 
REFERRAL GUIDELINES | PHARMACY GUIDELINES
 
Referral Guidelines
Allergy Consultations
Ambulance-Air Ambulance
Audiology
Behavioral Health referrals
Blepharoplasty
Breast Pump
Cardiac Rehab
Case Management and Patient Referal Form
Chiropractic Care
Chronic Catheterization, Mgmt of Patients on
Chronic Pain Management of Patients
Criteria for BH Emergency Ambulance Transport_ attachment
Diabetes, Foot Care
Diabetic Education
Diabetic Education_Contracted Providers
DME - Apnea
DME - Nebulizers
DME - Purchase vs. Rental
DME - Supportive Devices for Feet
DME - Therapeutic Shoes
DME CPAP-BIPAP
EEG Electroencephalographic Monitoring
Electrical Bone Growth Stimulation
FORM - Pharmacy PA Form - 6-06
FORM_ Pharmacy GI Med prior auth
Formulary Overrides
GERD_Gastroesophageal Reflux Disease
Glucometers
Hammertoe Syndrome
Heel Spur Syndrome
Hepatitis A
Home Health
Hysterectomy
Infusion Therapy
Ingrown Toenails
Intermetatarsal Neuroma
Intradiscal Electrothermal Therapy
MRI of Breast
Neurology-EMG-NCV Consults
Neuropsychological Evals
Occupational-Hand Therapy
Orthopedic Referrals
Ostomy Supplies
Oxygen Therapy
PET Scan
Physical Therapy
Polysomnography - Sleep Disorder
Pulmonary Rehabilitation
Rehabilitation Admissions
Rheumatology
Table of Contents for Referral Guidelines
TENS Unit - Supplies
Total Body Photography
Tubal Ligations
Vasectomies
Viscosupplementationfor Osteoarthritis
Pharmacy Guidelines
Disclaimer
P.G. 1 DIGESTIVE ENZYMES
P.G. 3 LAMISIL® (TERBINAFINE)
P.G. 4 GROWTH HORMONE THERAPY FOR CHILDREN
P.G. 5 DURAGESIC® (FENTANYL) PATCHES
P.G. 7 COX-2 INHIBITOR – Celebrex
P.G. 8 ARAVA® (LEFLUNOMIDE)
P.G. 9 PROTON PUMP INHIBITORS FOR GASTROESOPHAGEAL REFLUX DISEASE (GERD)
P.G. 10 SECOND-GENERATION ANTIHISTAMINES
P.G. 11 SYNAGIS® (Palivizumab) ADMINISTRATION
P.G. 12 PSYCHOTROPIC MEDICATION REFERRAL AUTHORIZATION
P.G. 15 PLAVIX® (Clopidogrel)
P.G. 16 NEUPOGEN®
P.G. 17 BLOOD GLUCOSE MONITORING SUPPLIES
P.G. 18 THIAZOLIDINEDIONES (PIOGLITAZONE - ACTOS®, ROSIGLITAZONE - AVANDIA®)
P.G. 19 HEPATITIS C: TREATMENT IN ADULTS
P.G. 20 INHALED STEROIDS
P.G. 21 LEUKOTRIENE INHIBITORS
P.G. 22 TOPAMAX® (TOPIRIMATE) FOR MIGRAINE PROPHYLAXIS
P.G. 23 JANUVIA® (SITAGLIPTIN)
P.G. 24 LYRICA® (PREGABALIN)
P.G. 25 TOBACCO CESSATION
Important Phone Numbers
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