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Get Orthonet Fax Request Form
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How to use or fill out the Orthonet Fax Request Form online
Filling out the Orthonet Fax Request Form online is a straightforward process that facilitates communication between providers and OrthoNet for therapy requests. Follow these steps to ensure accurate and complete submission.
Follow the steps to successfully complete the Orthonet Fax Request Form.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Fill out the Fax Date and Number of Pages Faxed sections at the top of the form. This helps in tracking the transmission details.
- In the Therapy Provider Information section, provide the Facility Name, Street Address, City, State, Telephone Number, Zip, Fax Number, OrthoNet Provider ID Number, Aetna Provider ID Number, and National Provider Identifier (NPI) details accurately.
- Proceed to the Referring Physician's section. Enter the Aetna ID Number and Individual NPI Number of the physician referring the therapy.
- Next, fill out the Patient Information section with the patient's First Name, Last Name, Member ID Number, and Date of Birth. Ensure that every field is accurate to avoid delays.
- In the Request Information area, indicate the Service Type, Initial Evaluation Date, and the diagnosis code. You can check whether this request involves post-operative therapy by answering 'Yes' or 'No' for the relevant question.
- Lastly, provide the number of additional therapy visits requested. Double-check all filled information to ensure its correctness.
- After confirming all the required fields are completed, you can save the changes, download, print, or share the completed form.
Complete your Orthonet Fax Request Form online today for efficient processing.
OrthoNet and Optum are not the same, although they are interlinked. OrthoNet specializes in orthopedic management services, while Optum provides a broader range of health services. Together, they offer a comprehensive platform that includes the Orthonet Fax Request Form, making the process of managing orthopedic authorizations much simpler.
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