Health Services

​Utilization Management

Submit a RAF or TAR Online

Forms - If online services are not available, please use RAF and TAR forms.

• Referral Authorization Form (RAF)
• Treatment Authorization Request (TAR) Requirements
• TAR Form
• Long-Term Care - TAR
• Bed Hold & Change of Status Report

​Health Education

The Health Education (HE) Services is a resource for assisting you in providing appropriate health education tips/materials for your members. Many are available in languages other than English.

• Health Education
• Health Information Resources
• Language Assistance

​Care Coordination

The objective of the Care Coordination group is to proactively invite members and their providers to participate in programs that will maximize positive health outcomes and satisfaction; educate providers about all case management programs with the latest protocols; and encourage providers to refer members to the appropriate programs.

• Basic Population Health Management
• Tansitional Care Services
• Complex Case Management
• Learn More

​Pharmacy

PHC Pharmacy department is responsible for the management of the medical drug benefit (provider administered drugs/PADs) and medical drug expenditure control. State Medi-Cal contracts with Magellan to provide pharmacy services through Medi-Cal RX

• Medi-Cal Rx Covered Drug List
• Learn more about Rx here
• Magellan Medi-Cal Rx Provider Portal

​Quality Improvement

Improving quality and service to our members are strategic priorities of PHC. Our Quality Improvement Department supports these priorities by implementing activities and programs directed at the following goals by improving the health of the populations we serve

Click here to learn more about Quality

​Medical Directors

The Medical Directors of PHC are dedicated to the health of our members and the larger community. A majority of their time is spent on traditional Utilization Management (UM) activities; working with UM nurses to ensure inpatient care and other medical procedures where appropriate and working with the pharmacists and the pharmacy services team on authorizations for non-formulary medications.​

Hospitalist Leadership Meeting with PHC Medical Directors

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Emergency Department Leadership Meeting with PHC Medical Directors

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