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How to use or fill out the OUTPATIENT PHYSICIAN ORDER FORM - High Point Regional online
Filling out the Outpatient Physician Order Form is an essential step in ensuring that patients receive the necessary imaging services. This guide provides a detailed walkthrough of each section of the form to assist users in completing it accurately and efficiently.
Follow the steps to complete the outpatient physician order form online.
- Press the ‘Get Form’ button to access the form and open it in the designated editing interface.
- Begin by entering the patient's information. Fill in the patient’s name, date of birth, phone number, and select the gender by circling either 'Male' or 'Female'. Also, provide the patient’s Social Security number and the date/time of the exam.
- In the insurance information section, input the primary insurance company name, policy number, and group number. If applicable, provide the secondary insurance information in the same format.
- Indicate whether pre-authorization or notification is required by circling 'PreAuth', 'PreCert', 'Notif', or 'N/A' and provide the corresponding number if necessary.
- Specify the reason for testing by filling out the reason for the exam and ensure to include an ICD-9 code. Note: using phrases like 'rule out' or 'follow-up' is not permitted.
- Select the desired examination type and corresponding CPT code from the available options provided in the section. Circle the appropriate exam and write down the corresponding CPT code.
- Complete any additional details if necessary, ensuring to provide clear and concise information.
- Once the form is filled out completely, review all sections for accuracy. After confirming that all information is correct, you may choose to save your changes, download, print, or share the completed form as needed.
Start completing the outpatient physician order form online today to ensure timely and accurate patient care.
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When was High Point Medical Center built?
High Point Medical Center, one of the region's premier health care providers, traces its roots all the way back to 1904 with the opening of a hospital in High Point to treat typhoid fever.
What is the biggest hospital in NC?
Duke University Hospital – 1,048 beds The 1,048-bed Duke University Hospital, located in Durham, is the biggest hospital in North Carolina. The tertiary teaching hospital provides comprehensive diagnostic, medical and surgical services across a range of specialities.
What is High Point Regional hospital called now?
Wake Forest Baptist Health – High Point Medical Center is a 351-bed hospital in High Point, North Carolina, that serves the residents of High Point and surrounding areas.
Who bought High Point Regional hospital?
Last fall, Wake Forest Baptist and UNC Health Care signed a letter of intent in which Wake Forest Baptist would acquire and integrate High Point Regional and its affiliates into their health care system. In March 2018, a definitive agreement advanced the process to transition ownership.
What is the history of High Point Medical Center?
High Point Medical Center has a deep, rich history in the community that began in 1904. As the organization grew over time, the hospital developed into the health system that we have today. That growth has helped us continue to fulfill our mission to provide exceptional health services to the people of our region.
What is the mission statement of High Point Medical Center?
Atrium Health Wake Forest Baptist High Point Medical Center's vision is to be the first and best choice for care. Atrium Health Wake Forest Baptist High Point Medical Center's mission is to improve health, elevate hope and advance healing – for all.
What is the history of Bowman Gray School of Medicine?
The Medical Center was established in 1941, when the medical school was expanded to a four-year institution and moved from Wake County to its present site adjacent to Baptist Hospital in Winston-Salem. It was renamed Bowman Gray School of Medicine in memory of the benefactor who made the expansion possible.
What is the largest hospital in Asheville NC?
Mission Hospital, located in Asheville, North Carolina, is Mission Health's flagship hospital, licensed for 815 beds.
What level of trauma is High Point Medical Center?
“High Point Regional continued to offer all the clinical services required of a Level 3 trauma center, including a 24/7 emergency department, orthopedics, general surgery and anesthesia,” Wolf, of UNC Health, wrote in an email.
What is the name of the hospital in High Point NC?
High Point Medical Center | High Point, NC | Atrium Health Wake Forest Baptist.
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