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Get Prometheus Test Requisition
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How to fill out the Prometheus Test Requisition online
Filling out the Prometheus Test Requisition online is an essential step for healthcare providers to request the necessary tests for patients. This guide aims to provide clear and detailed instructions to ensure a smooth completion of the form.
Follow the steps to accurately complete your Prometheus Test Requisition.
- Click ‘Get Form’ button to obtain the Prometheus Test Requisition form and access it in your preferred online editor.
- Begin by filling out the Physician / Account Information section. Include the account name and address relevant to the testing laboratory, as well as the contact phone and fax numbers.
- Complete the date collected and time collected fields. Ensure to assign a unique Patient ID and SENDER SAMPLE ID as per the information required.
- If applicable, indicate the Medicare hospital status at the time of sample collection by selecting from Inpatient, Outpatient, or Non-Hospital Patient.
- Fill in the required ICD-9 codes along with the clinical diagnosis to justify the medical necessity of the tests ordered.
- Provide the Patient Information including the last name, first name, middle initial, full address, and contact numbers. Ensure that the date of birth, sex, and social security number are accurately recorded.
- In the Billing Information section, specify whether the billing will be done under the account, insurance, laboratory, or patient. Complete the details of the insurance carrier, policy number, and group specifics as required.
- Select the appropriate tests to be performed by checking the relevant boxes for each Prometheus test indicated in the form.
- Acquire the necessary signatures for the ‘Ordering Physician’s Signature’ section along with the date. If the patient is a minor, include the information of the parent or guardian and their signature.
- Review the findings and ensure all required fields are completed accurately. Once done, you can save changes, download, print, or share the form as needed.
Complete your Prometheus Test Requisition online today for efficient testing!
A test requisition is a key document that healthcare providers use to request laboratory tests for their patients. It contains details about the patient and the specific tests needed, like the Prometheus test requisition. This organized approach helps streamline the testing process and ensures accurate results for better healthcare management.
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