Healthy Kids

Referral Authorization Form (RAF)
Treatment Authorization Request (TAR) Form
Treatment Authorization Request (TAR) Extension Form

Healthy Kids Claims Mailing Address:

Partnership HealthPlan of California
Claims Department
P.O. Box 3172
Suisun City, CA 94585-3172

Note: Different from Medi-Cal Claims mailing address

Authorization is Required for Out of County Referrals

When referring to a specialist not located in the member's county of residence, you must have approval from PHC prior to member seeing specialist.

Note: Our Provider Manual, Practitioner Manual and other files are in PDF format that require the Adobe Acrobat Reader. You may obtain a copy of the free Acrobat Reader software and installation instructions for Macintosh, UNIX or Windows from Adobe Systems Incorporated.