Get Ngs American Outpatient Pre-certification Review

This guide provides clear and detailed instructions for completing the NGS American Outpatient Pre-certification Review online. Tailored for a broad audience, this resource will help ensure you navigate the precertification form with confidence and ease.

Follow the steps to successfully complete the NGS American Outpatient Pre-certification Review form online.

1. Click ‘Get Form’ button to obtain the NGS American Outpatient Pre-certification Review and open it in your preferred form editor.
2. Begin by entering the employee's name in the designated field, ensuring correct spelling for proper identification.
3. Provide the employee's I.D. number or Social Security Number (SSN) in the corresponding section.
4. Input the patient's complete name as required for identification purposes.
5. Fill in the patient's date of birth using the appropriate format.
6. List the referring physician's name and their contact phone number to facilitate communication regarding the patient's care.
7. Document the rendering provider's name and their professional credentials in the specified fields.
8. If applicable, include the referring physician’s name who is directing the services along with their phone number.
9. Provide the rendering provider’s tax identification number in the designated field.
10. Enter the return fax number for any follow-up or communication regarding the precertification.
11. Detail the treatment to be performed in the provided space, followed by the corresponding CPT code.
12. Describe the treatment by writing an accurate description and entering the expected quantity or units.
13. Indicate the first date of treatment and the number of visits the patient has had to date.
14. Clarify if the treatment is accident-related by marking the appropriate box.
15. In the frequency and duration section, specify the condition or diagnosis and the frequency of visits (e.g., per week or month). Also indicate if the treatment is work-related.
16. You may be prompted to provide names and phone numbers of contact persons as necessary.
17. Attach any required documentation such as the referring physician’s prescription and treatment plans, therapist’s evaluation, necessary goals, and physician orders.
18. Double-check all the entered data for accuracy before proceeding.
19. Once completed, users can save changes, download the document, print it, or share it as necessary.

Complete your NGS American Outpatient Pre-certification Review online today!