Mo. Rev. Stat. § 376.1403: Referrals, standardized information used, content, when.

1. Every health care provider and health carrier that conducts business in this state shall use standardized information for referrals. As used in this section, the terms "health care provider" and "health carrier" shall have the meaning given to such terms in section 376.1350.

2. The referral information shall contain the following:

(1) The name of the insured;

(2) The name, address and phone number of the health carrier;

(3) The identification number and group number of the insured;

(4) The type of referral;

(5) The name, address and phone number of the health care provider referring the insured;

(6) The name, address and phone number of the health care provider to whom the insured was referred to;

(7) The number of visits requested and authorized; and

(8) The health carrier's authorization number.

3. All health care providers and health carriers shall use the standardized referral information after January 1, 2002.