For Providers

Making a referral is fast and easy. Please fax your patient's orders and insurance information and let EAMC handle the rest. Be advised, some pre-determinations may take longer than others. We will do our best to get them approved as soon as possible. Please Fax orders for Outpatient Infusion Center to 334-528-1510, and please fax orders for Home Infusion/Specialty to 334- 528-3946.

Referral Instructions:

In order to provide the best service for you and your patients, we ask that all required information accompany your referral paperwork when faxed to the Infusion Center. Please provide recent clinical note documentation that specifies and supports the patient’s diagnosis, ICD 10 code, tried and failed therapies (if applicable), recent labs and test that support diagnosis and requested service, along with a valid order for treatment

Required Documentation:

Orders:

Complete doctors’ orders that include NPI, diagnosis and ICD 10 code, dosage, frequency, and prescriber’s signature. A new order may be required for each visit depending on what service is rendered.

Clinic Note:

Last Office visit note with any tried and failed treatments

Labs*:

• Pertinent labs (especially CMP, and P1) within 30 days of requested service.
• Provide proof of Hepatis B ,TB , IgG/subclass, uric acid, G6PD,and JC virus results for applicable therapies. Please advise patients if ordered services requires them to present for labs on the day of service.

Diagnostics*:

Applicable DEXA scan results and/or FRAX score. *If performed at East Alabama Medical Center, you do not have to fax.