Get Or Scheduling Form.pdf - Bakersfield Heart Hospital

Filling out the OR Scheduling Form is an essential step in scheduling surgeries at Bakersfield Heart Hospital. This guide will provide clear instructions on each section of the form, helping users complete it accurately and efficiently.

Follow the steps to complete the OR Scheduling Form effectively.

1. Press the ‘Get Form’ button to access the OR Scheduling Form and open it for editing.
2. Fill in the surgery date by clearly indicating when the surgery is scheduled to take place.
3. Enter the name of the surgeon and the assistant who will be involved in the procedure.
4. Specify any allergies the patient may have, including latex or other allergens.
5. Provide the patient's full name, date of birth, and social security number in the designated fields.
6. Indicate the patient's gender, and fill in the contact information including address, primary phone, work number, cell phone, and pager details.
7. List the procedures and include relevant CPT codes associated with the surgery.
8. Estimate the case length and indicate the requested start time for the procedure.
9. Document the diagnosis and specify the appropriate anesthesia type: general, outpatient, MAC, spinal, AM admit, or ICU bed post-operative.
10. If there are any equipment requests, include details about implants or equipment required and the vendor or representative's information.
11. Complete the insurance information by filling in whether the patient has industrial coverage and providing details about the primary and secondary insurance, including policy numbers and adjuster information.
12. Indicate whether the deductible has been met and provide the hospital authorization number, if applicable.
13. Make a note of any comments or additional information that may be necessary for the hospital.
14. Finally, save your changes, and download or print the completed form. Ensure you fax it to 661.852.6281 or contact the hospital at 661.852.6280 with any questions.

Complete your OR Scheduling Form online today for a seamless surgical scheduling experience.