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Get Coaguchek Physician Order Form 2020-2026
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How to fill out the Coaguchek Physician Order Form online
The Coaguchek Physician Order Form is a crucial document for enrolling patients in self-testing services. This guide provides a comprehensive approach to completing the form online, ensuring accuracy and compliance with required information.
Follow the steps to successfully fill out the Coaguchek Physician Order Form online:
- Press the ‘Get Form’ button to obtain the Coaguchek Physician Order Form and access it in your online editor.
- Complete the patient information section. This includes the patient's first name, middle initial, last name, gender, home address, city, state, zip/postal code, primary and secondary phone numbers, date of birth, and email address if available.
- Enter the patient's diagnosis code(s). Ensure you provide all applicable ICD-10 diagnosis codes. This is essential for processing their insurance coverage.
- Specify the therapeutic range needed for the patient, including the low and high INR values.
- Designate the notification range for abnormal INR results. Input the contact person for patient results, including their title, phone number, fax number, and email address.
- Indicate the prescribed frequency for testing per month, selecting one of the available options.
- Choose the patient training method. Indicate whether training will occur at the clinic or by Coaguchek Patient Services.
- The physician must provide a hand-written or electronic signature, date, and enter their NPI number. Also, complete the physician and clinic information section.
- Fill out the insurance information, including the primary and secondary insurance company names, policy ID numbers, and customer service phone numbers.
- Review the completed form for accuracy and completeness before submitting.
- Once all fields are completed accurately, save the changes, download, print, or share the Coaguchek Physician Order Form as needed.
Complete the Coaguchek Physician Order Form online today to streamline your patient enrollment process.
The CPT code for CoaguChek testing varies depending on the specific test being performed. Typically, the code will be listed in the CoaguChek Physician Order Form, which helps streamline billing and insurance claims. It's vital to use the correct code to ensure reimbursement from insurance providers. Always check for the latest CPT coding updates.
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