Get Bcmnb - Forbes Rehab Services

Filling out the BCMNb - Forbes Rehab Services form is a crucial step in obtaining necessary medical equipment. This guide provides clear, step-by-step instructions on how to navigate the online form effectively, ensuring that all required information is completed accurately.

Follow the steps to successfully complete the form online:

1. Press the ‘Get Form’ button to access the BCMNb - Forbes Rehab Services form and open it in your preferred digital editor.
2. Begin by entering the correct certification type and date in Section A, along with the patient's name, address, telephone number, and member number.
3. Fill in the supplier's information, including the address, telephone number, and relevant identifiers such as NSC and NPI numbers.
4. Provide the patient’s date of birth, sex, height, and weight in the designated fields.
5. List the HCPCS code that corresponds with the equipment requested.
6. In Section B, carefully complete the patient’s information, ensuring that the estimated length of need and diagnosis codes are filled out accurately.
7. Indicate if the patient is confined to bed and provide the percentage of time they are bedridden.
8. Detail the type of equipment ordered and the duration of the need. Note any specifications if the duration exceeds 12 months.
9. Record the date of the patient’s last visit to the prescribing physician and the date the equipment was prescribed.
10. If the questions in Section B are answered by someone other than the physician, provide their name, title, and employer clearly.
11. Proceed to Section C to write a narrative description of the prescribed equipment, including item charges and Medicare allowances.
12. In Section D, the prescribing physician must sign and date the form, ensuring that no stamps are used.
13. Finally, review all entries for accuracy and completeness before saving your changes, downloading, and sharing the completed form as needed.

Complete your BCMNb - Forbes Rehab Services form online today to facilitate your medical equipment needs.