Get Physician Query Form

Filling out the Physician Query Form online is a crucial step in documenting a patient's medical condition accurately. This guide will help you navigate the form effectively, ensuring that all necessary information is provided clearly and concisely.

Follow the steps to complete the Physician Query Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the digital platform.
2. Enter the date in the designated field at the top of the form.
3. Document the physician's name in the space provided.
4. Fill in the coder’s name and phone number to ensure accurate communication.
5. Insert the patient’s name, admit date, medical record number, discharge date, and account number in their respective fields.
6. Review the clinical indicators listed and check the box next to each indicator that is present in the medical record.
7. Based on your medical judgment, answer the query regarding whether you are treating the patient for generalized sepsis by selecting 'Yes', 'No', or 'Unable to determine'.
8. If you select 'Yes', provide the specific diagnosis and responsible organism in the space available and ensure it is noted in the medical record as well.
9. Complete the physician signature and date fields at the bottom of the form to finalize your responses.
10. Once all information is accurately filled out, save your changes. You may download, print, or share the completed form as needed.

Complete and submit your Physician Query Form online today to ensure accurate medical documentation.