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Get Surgery Paperwork
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How to fill out the Surgery Paperwork online
Filling out the Surgery Paperwork online is an important step in obtaining prior authorization for spinal surgery procedures. This guide will provide you with a comprehensive overview of each section of the form, ensuring that you complete it accurately and efficiently.
Follow the steps to successfully complete your Surgery Paperwork.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Start with the provider information section. Fill out the provider name, fax date, street address, city, state, and the National Provider Identifier (NPI). Make sure to include your telephone and fax numbers along with the provider tax ID numbers.
- Proceed to the patient information section. Here, enter the patient's first and last name, Humana member ID number, date of birth, and diagnosis code. Ensure that all information is accurate and complete.
- In the request information section, indicate the relevant spinal levels for the procedure. Check the appropriate boxes for spinal decompression, spinal fusion, or vertebroplasty/kyphoplasty, and specify the setting as inpatient or outpatient.
- Indicate if the patient has had prior spinal surgery, and if so, provide the date of the most recent surgery.
- Document whether the patient has had an MRI or CT in the past six months, and confirm if the report is attached to the request.
- Attach relevant clinical documentation, including the current office notes that support the proposed procedure, as well as the anticipated date of service.
- Review all entries for accuracy. Once all sections are complete, you can save changes, download, or print the form as needed.
Begin the process of completing your Surgery Paperwork online today.
To write a surgical history, compile a comprehensive overview of the patient’s surgical experiences. Include information like the types of surgeries, dates performed, results, and any complications encountered. This documentation not only serves as a reference for future surgeries but is also a critical aspect of meticulous Surgery Paperwork.
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