Get Peer-to-peer Physician Agreement Rev 4-1-19.docx

Filling out the Peer-To-Peer Physician Agreement is essential for participating in the CNNH NeuroGenomics Program. This guide provides detailed instructions on how to complete the form efficiently and accurately, ensuring a smooth process for both the physician and the patient.

Follow the steps to fill out the Peer-To-Peer Physician Agreement successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering your personal information in the designated fields, including your full name, medical credentials, and contact information. Ensure accuracy to facilitate communication.
3. Review the purpose and goals of the Peer-To-Peer service outlined in the document. A clear understanding of these will help you align your expectations with those of the program.
4. Proceed to the section detailing pre-testing procedures. It's important to acknowledge your responsibilities regarding genetic testing orders and insurance coverage.
5. Fill out the billing section where you will select the level of service (Focused, Standard, or Comprehensive). Understand the expected time commitment associated with each level.
6. Review the responsibilities section carefully. Agree to the terms outlined regarding patient communication, scheduling, and sending medical records.
7. Sign and date the agreement in the provided fields to indicate your consent to participate in the Peer-To-Peer service.
8. Once all fields are filled out correctly, save your changes. Options to download, print, or share the completed form will typically be provided in the online editor.

Start completing your Peer-To-Peer Physician Agreement online today for a seamless experience.