Here's how it works
01. Edit your what type of insurance is gold coast health plan online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out Health Education Referral Form - Gold Coast Health Plan - goldcoasthealthplan with our platform
- Click ‘Get Form’ to open the Health Education Referral Form in the editor.
- Begin by filling out the PATIENT INFORMATION section. Enter the member's last name, first name, middle initial, and member ID number. Provide the address, primary and secondary phone numbers, date of birth, city, state, and zip code.
- Next, move to the REFERRAL INFORMATION section. Here, input the treating physician's name along with their phone and fax numbers. Also include the primary care physician's (PCP) name and contact details.
- In the REASON(S) FOR REFERRAL TO GOLD COAST HEALTH PLAN HEALTH EDUCATOR section, check all applicable boxes that correspond to the patient's condition such as Diabetes or Asthma.
- Finally, complete the CLINICAL INFORMATION section by having the treating physician or office staff fill in their name, title, phone number, and date of completion.
Start using our platform today for free to streamline your form completion process!
Fill out Health Education Referral Form - Gold Coast Health Plan - goldcoasthealthplan online
It's free
It's free
See more Health Education Referral Form - Gold Coast Health Plan - goldcoasthealthplan versions
We've got more versions of the Health Education Referral Form - Gold Coast Health Plan - goldcoasthealthplan form. Select the right Health Education Referral Form - Gold Coast Health Plan - goldcoasthealthplan version from the list and start editing it straight away!
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2024 | 4.7 Satisfied (24 Votes) | |
| 2023 | 4.3 Satisfied (27 Votes) | |
| 2023 | 4.1 Satisfied (45 Votes) | |
| 2023 | 4.1 Satisfied (46 Votes) | |
| 2023 | 4.4 Satisfied (35 Votes) | |
| 2022 | 4.8 Satisfied (52 Votes) | |
| 2022 | 4.6 Satisfied (28 Votes) | |
| 2021 | 4.8 Satisfied (61 Votes) | |
| 2021 | 4.8 Satisfied (31 Votes) | |
| 2021 | 4.7 Satisfied (124 Votes) | |
| 2021 | 4.8 Satisfied (145 Votes) | |
| 2021 | 4.8 Satisfied (89 Votes) | |
| 2021 | 4.8 Satisfied (49 Votes) | |
| 2021 | 4.5 Satisfied (36 Votes) | |
| 2021 | 4.2 Satisfied (40 Votes) |
Got questions?
We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
What is the phone number for Gold Coast Health Plan?
Reach Our Member Services Department We can answer your questions in English or in Spanish. If you speak a language other than these, we will be happy to provide the interpreter services you need. Just give us a call at 1.888. 301.1228.
Is Gold Coast Health Plan a Medicaid plan?
What is Gold Coast Health? Gold Coast was created by the Ventura County Board of Supervisors 13 years ago to administer Medi-Cal insurance to low-income residents. Though its defined as a county-organized health system, it operates as an independent public entity and does not answer directly to the supervisors.
How do I contact the Gold Coast?
Urgent enquiries and emergencies At all times (including after hours), call us on 1300 GOLDCOAST (1300 465 326) and choose option 1 to be diverted to our Emergency Service number.
Is Medi-Cal the same as Gold Coast Health Plan?
GCHP is your health plan in Ventura County after you qualify for Medi-Cal. You will be automatically enrolled in GCHP one to two months after you are eligible. GCHP will send you a new member packet. GCHP covers most Medi-Cal services.
How do I contact the Gold Coast Health Plan?
If you would like more information, call GCHP at 1.888. 301.1228. If you use a TTY/TDD, call 711.
Security and compliance
At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.
Learn more
People also ask
What is the timely filing limit for Gold Coast Health Plan claims?
FAQs for Providers Regarding Claims Payment Issues Claims submitted beyond 365 days from the date of service or date of discharge will be denied.